The Lancet Oncology Commission provides some excellent insights into the different drivers that shape cancer care, including imaging, radiography, surgery and hospital services, and drugs. However, the cost of drugs has dominated the subsequent press response and much of the commentary. This focus has arisen despite the Commission stating that the cost of drugs accounted for only about 13% of total US health-care expenditure in 2009. A similar percentage has been calculated for the cost of cancer care in New Zealand, where in a 6-year review the cost of drugs accounted for 10% of the total cost of cancer care per patient.Although much of the debate has centred on the perceived escalating cost of cancer drugs, I would emphasise two other aspects that will reshape the cost-benefit outlook for cancer treatments. First, personalised medicine, as noted briefly in the Commission, is playing an increasing part in the cancer care framework.
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