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In Reply

Departments of Epidemiology and Biostatistics and Medicine, Memorial-Sloan Kettering Cancer Center, New York, NY

Dr de Lemos suggests that even if oncologists do not explicitly factor costs into their treatment recommendations, they make these decisions subconsciously or at least implicitly. This assertion seems entirely plausible, although it cannot be established from our small pilot survey.¹ We note that physician attitudes toward the cost of therapy have not been well studied. There is scarce information about how oncologists, or other health care providers for that matter, incorporate costs that will be borne by the patient into their treatment recommendations. Dr de Lemos also notes that decisions about cost require good information about the value of treatment—that is, how much benefit can actually be anticipated. The challenge for physicians and patients alike is that the benefit cannot be precisely specified for an individual, but rather is a range of possibilities. The manner in which physicians present or frame potential benefits may influence patients' willingness to accept treatment. Our pilot survey suggests considerable divergence of viewpoints within the oncology community and the need for further research and evaluation about how economic consequences of treatment are incorporated into therapeutic encounters.

AUTHOR'S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author or immediate family members indicated a financial interest. No conflict exists for drugs or devices used in a study if they are not being evaluated as part of the investigation. For a detailed description of the disclosure categories, or for more information about ASCO's conflict of interest policy, please refer to the Author Disclosure Declaration and the Disclosures of Potential Conflicts of Interest section in Information for Contributors.

Employment: N/A Consultant or Advisory Role: N/A Stock Ownership: NA Honoraria: N/A Research Funding: Deborah Schrag, Genentech Expert Testimony: N/A Other Remuneration: N/A

REFERENCE

1. Schrag D, Hanger M: Medical oncologists' views on communicating with patients about chemotherapy costs: A pilot survey. J Clin Oncol 25: 233-237, 2007[Abstract/Free Full Text]

Related Correspondence

• Communicating With Patients About Chemotherapy Costs
  Mário L. de Lemos
  JCO 2007 25: 2142 [Full Text]

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