Cancer costs put treatments out of reach for many

Medical costs are on the rise again. Read about the high costs of cancer treatments that are unfortunately becoming more and more out of reach, not only for the uninsured, but for the insured as well.

By Debra Sherman

(Reuters) – The skyrocketing cost of new cancer treatments is putting advances in fighting the deadly disease out of reach for a growing number of Americans.

Cancer patients are abandoning medical care because the costs are simply too high and medical bills — even among the insured — are unmanageable and put patients at a greater risk of bankruptcy, studies show.

“There’s a growing awareness that the cost of cancer treatment is unsustainable,” said Dr. Lee Schwartzberg, an oncologist who did a study examining the factors that contributed to patients quitting their oral cancer drugs.

Cancer is one of the most costly diseases to treat, largely because many patients are treated over a long term, often with expensive new drugs that are complicated to produce and not available in generic form. As insurance companies cut all benefits, reimbursements on cancer treatments have also declined.

“When it’s an expensive drug, we have to have the hard discussion about a very substantial out-of-pocket payment. I ask: ‘Do you want to spend this money for an average improvement of just a few months of life?’ I’m very uncomfortable having those discussions because I want to focus on the patient getting better,” Schwartzberg, medical director of the West Clinic in Memphis, Tennessee, said in an interview.

Schwartzberg’s and other cost studies presented at the American Society of Clinical Oncology (ASCO) annual meeting come as U.S. lawmakers battle over ways to reduce the national debt, including cuts in healthcare funding. (For full ASCO coverage, see [ID:nN05141382] )

ASCO president Dr. Michael Link, a pediatric oncologist, said access to healthcare should be a national priority.

INSURMOUNTABLE BARRIERS

“We’re thrilled with what we consider to be breakthroughs and wonderful new therapies … yet the barriers for some patients to get them is insurmountable. It is an indictment of how we take care of patients in the United States,” Link said.

Cancer is the second-leading cause of death in the United States, after heart disease. The incidence is expected to increase with an aging population.

The costs for cancer care topped $124 billion in 2010 in the United States, led by breast cancer, according to the National Cancer Institute (NCI). That number is expected to rise as more advanced treatments — targeted therapies that attack specific cancer cells and often have fewer side effects — are adopted as the standards of care. The NCI projects those costs to reach at least $158 billion by 2020.

Until recently, almost all cancer drugs were administered intravenously. Today, about a quarter of them can be given orally, which means fewer visits to the doctor. But pills are often more expensive, have higher co-payments, and are reimbursed by insurers at lower rates than IV drugs, he noted.

Using a database of pharmacy claims paid by private insurers and Medicare, he found, not surprisingly, that those with higher co-payments quit their drugs more often.

Patients with co-payments of more than $500 were four times more likely to abandon treatment than those with co-payments of $100 or less, Schwartzberg said. Claims with the highest co-payments had a 25 percent abandonment rate, compared with 6 percent for co-payments of less than $100.

“Prices of drugs can’t be set so outrageously high,” he said. “We have a problem with cancer care … All stakeholders have to get together and compromise to translate this great science into great patient care without breaking the bank.”

Dr. Yousuf Zafar, an internist at Duke University Health System, did a separate study on the impact high medical bills have on patients’ cancer treatment. (more…)

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Care costs continue brisk growth in 2011

Another study revealing the ever increasing rise in healthcare costs. Tell us something we don’t know. Will costs ever level off and maybe even decrease or is that just wishful thinking? At this point, I’ll take no increase over the double digit rise in premiums and the greater out-of-pocket expense. Americans continue to pay more and get less. What’s wrong with this picture?

By Tom Murphy

AP Business Writer

Health care costs have more than doubled for some American families over the past nine years, and they show few signs of dropping, according to a

The employee portion of costs paid for a family of four covered by the most common form of employer-sponsored health insurance will climb to a projected $8,008 this year from $3,634 in 2002. That amounts to an additional $84 a week from household budgets for health care.

Preferred provider organization plans are the most common form of employer-sponsored coverage.

The rise in health care costs is slower in 2011 compared to recent years, but they are still rising much higher than costs in other consumer areas, said consulting actuary Lorraine Mayne, one of the report’s authors.

“We don’t see anything on the near-term horizon that’s going to bend that downward,” she said.

The consulting firm compiled its annual health care cost measurement, known as the Milliman Medical Index, by studying provider fees, benefits and average health care use in all 50 states. Health care costs include insurance premiums for health care and other costs that come out of an employee’s pocket like co-payments, deductibles and co-insurance payments.

Employers still pay most of the total health care cost for families, but Milliman said the portion paid by the worker reached an all-time high of almost 40 percent this year.

Counting employers’ contributions, this year’s total health care cost for a family of four more than doubled to $19,393 from $9,235 in 2002. The 2011 figure represents a 7 percent increase compared to 2010.

Health care costs are rising mainly due to price increases in categories like pharmacy, inpatient or outpatient hospital care and doctors’ office visits. Mayne said these charge increases are a bigger factor than changes in health care use.

The national health care overhaul, which started unfolding last year and aims to eventually cover millions of uninsured people, had virtually no impact on health care costs for this year, Mayne said. She also doesn’t see the new law having any “direct, immediate impact” on the trend.

The Milliman report revealed nothing surprising to Helen Darling, CEO of the National Business Group on Health, a non-profit organization that represents large employers on health care issues. Darling, who was not involved in the study, said it offers more evidence of the “serious economic and financial dysfunction of the health care system.”

“The health care system continues to outstrip everything in its growth,” she said, noting that the economy “simply can’t support this kind of expense.”

Milliman said the total for health care costs varies around the country and doesn’t represent the total for all health care plans. Variables like costs and use can differ for government-sponsored Medicare and Medicaid coverage or other forms of commercial health insurance.

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