Cost-effectiveness and reimbursement issues in renal cell carcinoma.

The increasing focus on cost-effectiveness in all cancer care and the decision of many third-party payers to deny funding for investigational therapy is of particular concern in metastatic renal cell carcinoma. There is as yet no effective standard treatment for this disease; surgery, radiotherapy, and chemotherapy have all proved inadequate. The use of "investigational" therapy with biologic response modifiers, such as alpha interferon and interleukin-2, however, has shown promise. Investigational therapy, therefore, actually represents state-of-the-art treatment that offers the patient the best chance for increased survival, tumor regression, and improved quality of life. Under the current method of insurance reimbursement, however, investigational research is threatened despite the numerous reasons that such treatment is both cost-effective and therapeutically sound.