Are Cancer Treatments Becoming Prohibitively Expensive?
by Lisa DiFalco
No one looks forward to finding out that they have cancer. However, this is what is said to await over 1.6 million Americans every year. While treatments and new drugs are available, it appears that many patients choose not to fill their prescription or take less of a drug than prescribed. Such decisions may be due to the financial burden associated with treatments wherein patients may often not have the funds to pay out for exorbitant copays for drugs costing over $100K per year.
Cancer is a serious health condition that may prove deadly without timely treatment. Delays in filling prescriptions and not following prescriptions as directed can allow a condition to worsen and potentially spread within a person’s body. Needed drugs may serve to slow the progression of tumor growth, give patients a stronger chance in combatting the disease, and a longer lifespan.
New studies show that the costs associated with cancer drugs needed for treatment may make it difficult for a significant number of cancer patients to take the drugs as prescribed. Learn more about how cancer drug costs may impact cancer patients.
The Rising Price of Cancer Drugs
Many new cancer drugs can cost patients $100,000 or more a year. Alecensa is one of such drugs, recently prescribed to patient John Krahne. This drug is known to sell for over $159,000 a year. Krahne developed brain and lung tumors since his diagnosis 10 years ago. Now, he will delay filling his prescription as a new year of coverage kicks in and he scrambles to find money to afford the copay.
His story is one of many. A Kaiser Health news examination showed that “hundreds of thousands” of cancer patients are:
- Skipping drug treatment;
- Cutting pills in half; or
- Delaying care.
This is backed up with additional findings from a 2013 study where 25 percent of cancer patients elected not to fill prescriptions due to cost and approximately another 20 percent either took less than the amount prescribed or filled only a portion of the prescription. This is a serious concern as these behaviors may impact patient morbidity rates and may be hidden from treating physicians and healthcare professionals. Dr. Hagop Kantarjian, leukemia specialist and professor at Houston’s MD Anderson Cancer Center, said:
“Patients are being harmed daily [by high treatment cost]. It’s causing more deaths than necessary.”
A study published in the Journal of Clinical Oncology found that one-third of Medicare patients who were prescribed Gleevec had not yet filled their prescriptions within six months of their diagnosis. This leukemia medication can cost as much as $146,000 a year. Kantarjian believes that those that stop taking drugs such as Gleevec may run the risk of cutting years from their lives.
Many patients may have limited means to pay for the associated out-of-pocket costs for prescribed cancer drugs. As it currently stands, 59 percent of those diagnosed with cancer are over 65. In such cases, Medicare may pay for the bulk of treatment. However, a good portion of patients still struggles with copays. According to the Kaiser Family Foundation, out-of-pocket costs for cancer patients with Medicare may include:
- $7,227 annually for Zytiga (Prostate cancer);
- $8,503 per year for Gleevec (Leukemia; Gastrointestinal stromal tumor); and
- $11,538 a year for Revlimid (Multiple myeloma; Lymphoma).
The elderly may be hit hard with such copays, as 50 percent may have $13,800 or less in assets and more than one chronic condition. The Kaiser Family Foundation shared the median income for those on Medicare to be $24,150 in 2014. Whether individuals have supplemental insurance to pay for treatments not covered by Medicare, it is easy to see that the cost of copays may cut deeply into the available funds of seniors and the elderly. As Carla Tardif, chief executive officer at Family Reach, shared:
“[Some patients] have to choose between paying their meds and heating their home.”
The Struggle to Get Assistance
Krahne has continued to reach out for assistance in paying for the associated co-pays. He called time and time again to patient-assistance programs available and Genentech, Alecensa’s manufacturer, will help Krahne pay for his out-of-pockets costs. Krahne started taking the drug six weeks after first prescribed the drug, a considerable delay as he searched for financial assistance. Dr. Scott Ramsey, director of the Hutchinson Institute for Cancer Research at the Fred Hutchinson Cancer Center in Seattle, said:
“Most oncologists are OK with delays up to a month, but after that they start getting anxious that further delays will harm chances for survival.”
Many doctors are trying to help patients make difficult choices about balancing treatment costs with taking on potentially serious financial debt and even risking bankruptcy. Dr. Yousuf Zafar, associate professor of medicine and public policy at the Duke Cancer Institute in North Carolina, said:
“My job is to prescribe treatment. But I’m not doing my job if I prescribe a drug and walk away and leave them with tens of thousands of dollars in immediate debt.”
Novartis, Gleevec’s manufacturer, gave financial aid to a significant number of cancer patients. In 2016, 130,000 patients received assistance from Novartis. Novartis spokesman, Eric Althoff, said:
“We price our medicines to reflect the value they bring to patients and society. We also continue to invest in new treatments so that we can find ways to make more cancers survivable.”
The American Cancer Society has a range of programs and services to help individuals with cancer and their families deal with the complex issues that arise during treatment. Free rides to treatment, a personal patient navigator at a cancer treatment center, and online support communities may help patients find a way to more affordable cancer treatment.
Cancer patients, their families and the healthcare professionals that serve them are eager to find ways to continue necessary drug treatments without interruption or serious financial consequences to the patient. Fighting cancer is difficult enough without the debt that may accrue due to treatment. Easier and more readily available assistance is needed.