Leonard Saltz, MD: Bending the cancer cost curve: is it naive or feasible?
We previously interviewed NEJM author Tom Smith, MD, about is recommendations for lowering spending on cancer therapies. We then visited Memorial Sloan-Kettering Cancer Center to speak with well-known critic of expensive cancer drugs: Leonard Saltz, MD.
In Part 1, he gives his opinion on how feasible it will be to reduce the number of unnecessary CT scans and other tests that monitor tumor load and recurrences. He also discuss the merits of using only sequential monotherapy rather than cocktail therapy.
Interviewed by Steven Greer, MD
(Viewable in full-screen 1080i HD)
In Part 2, we discuss the practicality of limiting chemotherapy to those patients well enough to show a benefit. Currently, very frail end-of-life patients continue to receive chemotherapy even though it harms quality of life.
In Part 3, we discuss the proposal to reduce the usage of hematopoietic colony-stimulating factors (CSFs), such as Amgen’s Neulasta and Neupogen
In Part 4, we discuss broader policy issues.
Mem. Sloan-Kettering, NEJM, Oncology, Policy | apples49 | 
September 5, 2012 1:00 pm
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By Eli Glatstein MD, May 27, 2011 @ 11:21 am
I see no way to significantly reduce costs until we 1) eliminate fee for service mentality and 2) develop a governmental insurance option that will force changes in insurance companies in order for them to compete. Right now, despite Republican protestations of a “governmental takeover of health care” or “socialized medicine”, what we have is a system that is still run for and by private insurance companies.
I actually believe that, given the intransigence and hostilities within both parties, we should have a 1 year experiment where we allow people to signup either for present Medicare options OR to resign from Medicare in favor of whatever the Republicans and Mr. Ryan recommend (along with a one-time check to help support their system). I believe very few Republicans would take the second option despite their tough talk.
Eli Glatstein, MD
U Penn