Volume 198 - Issue 2
Over 150 potentially low-value health care practices: an Australian study
Author: Ian E Haines
Med J Aust 2013; 198 (2): 84-85. || doi: 10.5694/mja12.11694
Published online: 4 February 2013
Published online: 4 February 2013
To the Editor: The Medical Journal of Australia’s recent focus on making the best use of finite health resources is an essential discussion if Australia is going to continue to enjoy a high-quality and affordable health care system.
One study identified large-scale use of resources on health care practices with no proven benefit. In my area of oncology, these included the overdiagnosis and overtreatment of many ...
To the Editor: The Medical Journal of Australia’s recent focus on making the best use of finite health resources is an essential discussion if Australia is going to continue to enjoy a high-quality and affordable health care system.
One study identified large-scale use of resources on health care practices with no proven benefit.1 In my area of oncology, these included the overdiagnosis and overtreatment of many men with early-stage prostate cancer, although it did not also address the vast costs associated with treating the subsequent complications of the radical treatment interventions.
The study also did not address the widespread use of palliative chemotherapy for incurable cancer with very expensive drugs where the data, showing what are often tiny and questionable benefits, have often only been assessed by the company producing the drug.2
Kefford recently stimulated a debate about the use of ipilimumab for incurable metastatic melanoma.3 For a course of four treatments, this drug costs $120 000 per patient to extend one life by an average of 4 months when the same amount of money could provide a similar extension of life, plus many other benefits, for a large number of similar patients receiving palliative care.4 Which health care systems can afford to do both?
Fransen and colleagues identified the alarming projected costs for treating non-melanoma skin cancer from 2010–2015.5 It no longer seems appropriate for governments to continue to fund escalating and simple service interventions on a fee-for-service basis where the fees seem out of proportion to the benefits and complexity of the intervention.
Competing interests
No relevant disclosures.
References
- Elshaug AG, Watt AM, Mundy L, Willis CD. Over 150 potentially low-value health care practices: an Australian study. Med J Aust 2012; 197: 556-560.
- Haines IE, Gabor Miklos GL. Time to mandate data release and independent audits for all clinical trials. Med J Aust 2011; 195: 575-577. 0_i1142868
- Kefford RF. Drug treatment for melanoma: progress, but who pays? Med J Aust 2012; 197: 198-199. 0_i1142870
- Haines IE. Managing patients with advanced cancer: the benefits of early referral for palliative care. Med J Aust 2011; 194: 107-108. 0_i1142872
- Fransen M, Karahalios A, Sharma N, et al. Non-melanoma skin cancer in Australia. Med J Aust 2012; 197: 565-568. 0_i1142874