In years past, physicians have avoided the question as to whether cost of therapy should be considered in the treatment approach. As biologic therapy can cost far more than conventional pharmaceutical treatments, and patients are often asked to shoulder significant portions of that cost, it may be time to take the blinders off, according to an oncology roundtable.

At the National Comprehensive Cancer Network’s (NCCN) annual conference, roundtable participants suggested that it may be time to include cost information in treatment guidelines. Leonard Saltz, MD, of the Memorial Sloan-Kettering Cancer Center, New York City, claimed that physicians used to be “above the idea of considering cost.” That is no longer the case, according to the panelists.

David Ettinger, MD, of Johns Hopkins University, Baltimore, noted that if the guidelines (either from NCCN or other professional cancer societies) included cost data along with treatment protocols, “it might help doctors decide between two chemotherapy regimens for colorectal cancer that are similarly effective but vary widely in their cost.”

In related news, a survey of oncologists and rheumatologists regarding biologic therapy revealed that both of these specialists are now considering a cost discussion with their patients during the office visit.

The Biotechnology Monitor & Survey found that when nearly 100 physician practices were queried, two-thirds of rheumatologists responded that the costs associated with therapy had “more often become part of the conversation.” Sixty-two percent of responding rheumatologists said that when prescribing biologics, they considered the cost of therapy “frequently” or “all the time.” In comparison, 46% of oncologists talk to their patients about their out-of-pocket costs, and 48% considered cost of therapy at least frequently.

Interestingly, only 14% of rheumatologists indicated that cost is never considered in therapeutic decision making. Nineteen percent of the responding oncologists claimed to never consider cost of therapy in the clinical decision.

Presented at the 13th Annual Meeting of the National Comprehensive Cancer Network, Hollywood, FL, March 5–9, 2008. 2008 Biotechnology Monitor & Survey. Emron, Wayne, New Jersey, 2008 (www.biotechmonitor.com).