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…)