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Patients Dealing with Rising Cancer Treatment Costs

Posted on: Tuesday, 25 March 2008, 00:55 CDT

Its no secret that drug prices are high, but they pale in comparison with the skyrocketing costs of cancer treatments. For those patients with cancer, the question becomes ‘how much is enough?’

The costs of chemotherapy, for example, have risen so much that later this year, oncologists will be taught how to have a discussion with patients about the affordability of treatments. Some of these patients have cancer that cannot be cured. They become faced with the idea that by adding months or years to their life, they may be adding more and more debt to their family.

"These are awkward discussions," says Dr. Allen Lichter of the American Society of Clinical Oncology, which is writing the guidelines. "At least we can bring this out in the open."

Dr. Leonard Saltz of Memorial Sloan-Kettering Cancer Center uses the example of treatments for metastatic colon cancer. Both treatments are equally effective in treating the disease, but one costs $60,000 more than the other, and neither treatment is perfect. Irinotecan, the cheaper one results in hair loss, while the more expensive treatment, oxaliplatin can cause nerve damage in hands and feet.

"Is it a good investment, a high-risk investment, or buying a lottery ticket?" Saltz said.

Treatments costing upward of $100,000 are no longer unheard of . Lichter notes that the cost of cancer treatment is rising 15 percent a year. Another factor is the added length of life more people are now living. This causes them to require more supply of expensive drugs and treatments for a longer period of time.

Drug companies have made donations to medication to prescription-assistance programs such as the “Partnership for Prescription Assistance,” which will provide medication to patients who are unable to pay for them. But not all patients are given the best treatment on the first shot.

"As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it's a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm," says Dr. Neal J. Meropol of Philadelphia's Fox Chase Cancer Center, who is leading the panel writing ASCO's new guideline on how to weigh treatment costs.

Even some well-insured patients are struggling with rising costs.

Helen Geiger, for example, paid for a premium plan when Medicare began its Part D coverage. When she was diagnosed with multiple myeloma, she said the plan listed the cost of her dose of Thalomid at $5,500 a month but her copay was $60 a month.

Last year, her prescription plan changed Thalomid to be classified as a specialty drug with a $1,051 copay. As a result, she went months without the medication, as her doctors and family searched for an alternative.

"You don't need this kind of stress when you're sick," says Geiger, who finally stumbled onto a prescription assistance program that provided her free medicine.

At a meeting of the standard-setting National Comprehensive Care Network earlier this month, Sloan-Kettering's Saltz and other doctors urged adding chemo prices to standard treatment guidelines. It is their hope that the cost of cancer treatments becomes another side effect for the patient to consider when choosing the right plan for them.

"If there's a need to spend it, let's talk about it. If we can do it just as well less expensively, I think doctors should know that and be able to make a decision," Saltz says.

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On the Net:

American Society of Clinical Oncology

Memorial Sloan-Kettering Cancer Center

Partnership for Prescription Assistance

Fox Chase Cancer Center

National Comprehensive Care Network

Source: redOrbit Staff and Wire Reports

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