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Comparative Effectiveness Studies Explore Cancer, Trauma Care

Cheryl Clark, for HealthLeaders Media, April 18, 2012

However, explained Deborah Schrag, MD, principal investigator of the Center for Outcomes Research at the Dana Farber Cancer Institute, most of the participants in the original trial were patients younger than age 65. Most of the patients who are diagnosed with this form of cancer, and most of the 165,000 annual lung cancer deaths, however, are older than 65.

Schrag's report, which looked at Medicare and Surveillance, Epidemiology and End Result data for lung cancer, found that the survival benefit for Medicare beneficiaries treated with the three-drug cocktail was less than two months compared with patients treated with the two-drug regimen.

"We found that adoption of bevacizumab did not have a substantial benefit in the Medicare population with advanced non-small cell lung cancer," Schrag said at a Tuesday briefing. And while the drug may still have some benefit for people under 65, most of the people diagnosed with this disease are over age 65.

"In the future, for malignancies like NSCLC that disproportionately affect elderly patients or where the CMS covers a large proportion of treatment costs, negotiations with pharmaceutical sponsors of pivotal trials might mandate adequate representation of elderly patients and/or pre-planned subgroup analyses relevant to the Medicare population," the paper said.

Helicopters and Trauma Patients
The second highlighted paper, from Johns Hopkins University School of Medicine, attempted to settle the debate about whether helicopters used to rescue trauma patients actually save lives, compared with the use of ground emergency medical service transport.

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