There is good news to celebrate within cancer care. People are living longer, scientific and medical advances are offering innovative treatment options not previously possible, and professions across the cancer care continuum are developing increasing levels of specialisation. 

But this good news has implications for healthcare budgets. Continued improvement in cancer care may become stalled unless the health economics challenge of cancer care is met.

Can the concept of outcomes-based healthcare provide a solution? Is it something to welcome, or should we treat it rather with healthy scepticism? It is timely for all practitioners and stakeholders in cancer care to reflect on these questions.

 

Around 20-40% of healthcare spending is wasted

 

There is a misallocation of resources in cancer care. A 2010 report by the World Health Organization estimated that 20% to 40% of all healthcare spending is wasted. It is also evident that the price tag attached to some products in cancer care – be they new medicines, medical devices, or other services – are not reasonably proportionate to the real benefit they provide over existing or alternative treatments. Furthermore, the largest investments by healthcare systems do not always go to the developments that will make the most notable differences in outcomes for the patients.

Continued improvement in cancer care may become stalled unless the health economics challenge of cancer care is met.

Outcomes-based healthcare therefore addresses matters of real substance. But can it deliver on its promise, and make improvements in cancer care more sustainable? Perhaps it is still too early to tell. However, as a passionate advocate for better cancer care, I can say that I want it to work.

 

Cancer care spending decisions must be evidence-based

 

Investment and spending decisions in cancer care need to be more evidence-based and less based on ad hoc and politicised pathways. The opportunity for improvement offered by non-commercial innovation, such as enhanced multidisciplinary and multiprofessional care and the advances of all professional specialisms, deserve to be considered as candidates for investment by health budget holders on an equal footing to propositions put forward from the commercial sector.

 

We could all usefully know more about:

 
  • what outcomes-based healthcare really means;
  • its advantages and pitfalls;
  • its impact and resonance for specific areas of cancer care.

This is why we are putting the exploration of outcomes research, value-based healthcare and the tracking down of waste and inefficiency in cancer care at the heart of the agenda of the ECCO 2018 European Cancer Summit.