To begin, the Institute of Medicine has declared that cancer care in the US is a system in crisis. Do you agree?
Dr. Kelly: The word “crisis”, I think, may not be the best word to use. I certainly think that major changes are needed. If we, as a cancer community, do not take ownership of some of the problems that we will talk about today, then I think others will make the tough decisions for us.
What we have learned, especially in the last couple of years, is that costs will not constrain themselves and that we really are reaching a tipping point where we need to take definitive and direct action. Often, some uncomfortable actions will be required to get on back on path.
Some of the trends that are amplifying the crisis – as pointed out by the Institute of Medicine – is that we do have an aging population of, thankfully, more and more survivors. But, what we are seeing is a 30% increase in cancer survivors by 2020 as a result of many of the significant scientific treatment advances that we’ve been able to achieve in the last couple of years. But we are also seeing that the incidence of cancer is expected to go up approximately 45% by 2030. So, because of these changing or increasing patient survivors and increasing cancer numbers, we are seeing that the cost of cancer care is really, really going up. In the US we are expecting between 2010 and 2020 that there will be a 39% increase in the cost of cancer care up to $173 billion and some experts are even saying that this may be conservative estimate.
So, I think we certainly need to make changes. The current system that we have right now is not sustainable. So, some direct and often uncomfortable actions will need to be done in order to get us back on track. And to ensure that we continue to treat future generations with better and better treatments. So, some decisions are needed right now. I would agree that the system needs to be altered and, in some cases, needs to be dramatically fixed.
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