PMID- 17855717
OWN - NLM
STAT- MEDLINE
DCOM- 20080117
LR  - 20070914
IS  - 0361-6878 (Print)
IS  - 0361-6878 (Linking)
VI  - 32
IP  - 5
DP  - 2007 Oct
TI  - Litigating the science of breast cancer treatment.
PG  - 785-818
AB  - Beginning in the late 1980s, many health insurers refused to cover high-dose 
      chemotherapy with autologous bone marrow transplant (HDC/ABMT) for high-risk and 
      metastatic breast cancer patients. Insurers denied coverage because there was no 
      persuasive evidence of clinical effectiveness. In response, many women sued to 
      compel coverage. After years of litigation and the expenditure of approximately 
      $3 billion, randomized clinical trials (RCTs) showed that the procedure was no 
      more effective and possibly more harmful than conventional therapy. To understand 
      whether and how litigation contributed to the diffusion of the procedure, we 
      conducted a series of case studies that examine the litigation tactics and 
      strategies used by defense and plaintiffs' counsel. Despite the fact that 
      HDC/ABMT lacked proven scientific effectiveness, insurance defense attorneys were 
      unable to stop the procedure's diffusion. Plaintiffs' attorneys had a much easier 
      and more sympathetic story to tell and were able to exploit vulnerabilities 
      facing the defense.
FAU - Jacobson, Peter D
AU  - Jacobson PD
AD  - University of Michigan, USA.
FAU - Rettig, Richard A
AU  - Rettig RA
FAU - Aubry, Wade M
AU  - Aubry WM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Health Polit Policy Law
JT  - Journal of health politics, policy and law
JID - 7609331
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/administration & dosage/*economics
MH  - Bone Marrow Transplantation/*economics/legislation & jurisprudence
MH  - Breast Neoplasms/*economics/pathology/surgery
MH  - Combined Modality Therapy
MH  - Diffusion of Innovation
MH  - Evidence-Based Medicine
MH  - Female
MH  - Humans
MH  - Insurance Claim Review/*legislation & jurisprudence
MH  - Insurance Coverage/*legislation & jurisprudence
MH  - Neoplasm Metastasis
MH  - Randomized Controlled Trials as Topic
MH  - *Treatment Outcome
MH  - United States
EDAT- 2007/09/15 09:00
MHDA- 2008/01/18 09:00
CRDT- 2007/09/15 09:00
PHST- 2007/09/15 09:00 [pubmed]
PHST- 2008/01/18 09:00 [medline]
PHST- 2007/09/15 09:00 [entrez]
AID - 32/5/785 [pii]
AID - 10.1215/03616878-2007-030 [doi]
PST - ppublish
SO  - J Health Polit Policy Law. 2007 Oct;32(5):785-818. doi: 
      10.1215/03616878-2007-030.