This OncologySTAT article raises issues which to far beyond prostate cancer:  How does the profit motivated U.S. healthcare system influence therapy choices and research study outcomes?

Here is the first part of the article:

Prostate Cancer Trials Face Randomization Challenges in US
The Gray Sheet. 2010 Dec 13, M Hogan

Device marketing, patient preferences, physician bias and financial incentives can thwart attempts by comparative effectiveness researchers to randomize prostate cancer patients into clinical trials.

Better evidence on treatment options for men with localized prostate cancer remains among the top priorities of comparative effectiveness research programs in the U.S.

However, some speakers at a Dec. 2-3 meeting on comparative effectiveness research methodologies held in Bethesda, Md., by the National Institutes of Health and the Agency for Healthcare Research and Quality were skeptical that the research could best be conducted in the U.S.

“The key comparative research questions in prostate cancer will be answered, but they won’t be answered in this country,” said Anthony Zietman, professor of radiation oncology at Harvard Medical School, during a discussion about CER of surgical and radiotherapy treatments for prostate cancer. “They’re going to be answered in Britain.”

Zietman explained that the patient populations in the U.K., Canada and Sweden are not exposed to health care marketing in the same way people are in the U.S., and that repeated exposure to ads can influence treatment decisions.

“Surely they have been on the Internet, but they aren’t bombarded with billboards on the highway advertising the latest and greatest technology at their local hospital,” Zietman said.

As marketing in the U.S. becomes more intense, Zietman added, patients are bringing strong preferences with them as they seek health care.

Read more by going to:  OncologySTAT/Grey Sheet – Prostate Cancer Research Bias.

I will leave you to think about another quote from the article:

“The parties involved – whether they’re physicians, providers, payers, device companies – have a lot of money at stake on the table,” Penson said. “So there are financial incentives in the United States which are driving this, and frankly [presenting] a barrier to comparative effectiveness research and to patients’ making an informed decision.”

So true!  More about this tomorrow. 

Feel good and keep smiling!  Pat

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