Eric P. Winer, MD: Medical Economics – The Cost of Care

 

Dr. Eric Winer moderated a panel at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium focusing on medical economics and the cost of cancer care. How do we begin to address these issues?

Dr. Winer is Chief of Women’s Cancers at Dana-Farber Cancer Institute and a Professor of Medicine at Harvard Medical School.

 

The Group Room at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium was made possible by support from:

VIDEO TRANSCRIPT:

Selma Schimmel, Founder & CEO, Vital Options International:

Hello and welcome to the Group Room where we’re at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium. We have the pleasure of sitting with Doctor Eric Winer. Doctor Winer is Chief of Women’s Cancers at Dana-Faber Cancer Institute, and Professor of Medicine at Harvard Medical School.

Eric P. Winer, MD, Chief, Women’s Cancers, Dana-Faber Cancer Institute:

Hello. Good afternoon.

Selma Schimmel:

So Doctor Winer, we’re going to talk about a couple of things with you – the moderating panel on medical economics, the cost of care. Thank you for spending time with us on these two areas that you were involved in.

Eric P. Winer, MD:

There were two lectures that were given, they were very great lectures and largely focused on how to analyze cost in the setting of medical care, and how in the context of clinical trials and in the context of evaluation of new therapies or new diagnostic procedures we should be thinking about cost issues. I think what is most important here, though, is that the United States has now caught up with the rest of the world, and the rest of the world has worried about cost for quite some time. I think we now recognize, here as well, that there isn’t a blank check being written for health care as it perhaps once felt that there was. We have to make some decisions as a society about what is going to be worthwhile for people and what isn’t. And I think we have to be careful about those choices. I don’t think it makes sense for us to be embracing drugs or devices or tests that are extraordinarily costly that don’t have clear benefit for the patient. And I think this all comes back to what’s right for the patient. In general, if we have treatments that are of significant benefits, I think we’re going to figure out a way, somehow, to get them paid for. But it’s all of the treatments and all of the extra testing that is really very marginal where we have to be very careful, and we have to make sure we don’t waste money on what I would think of as pretty mediocre treatments and approaches so we have the funds available to cover what’s really going to be far more valuable therapies in the future.

Selma Schimmel:

Well, looks like there’s going to be some really hard decisions to be made.

Eric P. Winer, MD:

I think they’re very tough choices now. A doctor taking care of an individual patient should probably not be worrying about these issues other than to the extent that out-of-pocket expenses may affect the patients’ ability to receive a treatment or remain adherent to a medication. But society has to address these issues, and as doctors and as other healthcare providers and as patients if we don’t address these issues then they’re going to be addressed for us by insurers, and we don’t want that. So I think that as a community we have to come together and we have to determine what makes sense for, in this case, women with breast cancer, and what doesn’t make sense because otherwise we’re going to find that the third party pairs will be telling us what we’ll be doing.

Selma Schimmel:

Right, and that’s a discussion that has to include not only the clinicians and the researchers and the reimbursement area but the advocates themselves, and the patients that probably have the loudest voices here.

Eric P. Winer, MD:

Absolutely, but in my sense of this – and I feel the same way when it comes to involving advocates in research – is that the patients and the advocates who represent many of them tend to be extraordinarily thoughtful and reasonable. And people are able to use some common sense and they will look at a treatment that may have a very small benefited me, may be very small costly and say ‘gee, I don’t know if that makes sense when there are other pressing issues’.

Selma Schimmel:

Thank you for acknowledging the wisdom of the advocates.

Eric P. Winer, MD:

If you live with an illness you get to know the illness.

Selma Schimmel:

Thank you, Doctor Eric Winer, Chief of Women’s Cancers Dana-Faber Cancer Institute, and Professor of Medicine at Harvard Medical School.

Eric P. Winer, MD:

Thanks for having me.

Selma Schimmel:

Thanks again.

END OF VIDEO

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