Survival comes dear for cancer patients who need some new anticancer drugs.
In some cases, paying for cancer treatment can be an issue in itself. This is especially true when cancer treatment continues for an extended time and involves chemotherapy. Among cancer survivors younger than 65, one in five delay getting necessary cancer treatment or avoid it entirely just because of the cost, according to a 2006 study by the U.S. Centers for Disease Control and Prevention. This is especially true for the uninsured, but even with medical insurance the financial impact on the cancer patient can be considerable.
The dilemma is more difficult for cancer survivors than for other kinds of patients, according to the study, which was based on a national survey involving 52,000 people. Compared with 21% of cancer survivors, only 12% of those with other health problems found treatment too expensive to consider (at least temporarily).
Some chemotherapy drugs are relatively inexpensive, such as 5-FU and leucovorin. However, newer anticancer drugs are very expensive, especially when they are used in combinations. Whereas the drug costs for eight weeks of treatment with 5-FU and leucovorin will run in the $100–$300 range, adding oxaliplatin or irinotecan will increase this cost to $10,000 or more. The further addition of bevacizumab (Avastin) or cetuximab (Erbitux) will raise this cost to $20,000–$30,000. This is for the cost of the drugs alone.
When these therapies improve survival by only a few months, this presents troubling issues for cancer patients, their doctors, insurers, and society as a whole. As an editorial in The New England Journal of Medicine pointed out in 2004 (as these new drugs were coming on the market), ultimately their high cost could lead to across-the-board increases in copays and policy premiums that would be insurmountable even for relatively affluent individuals.
In the long run, therefore, to achieve a short-term benefit for some cancer patients, many people with other medical conditions may suffer earlier death or disability because they cannot afford effective treatment. Society continues to avoid grappling with these difficult issues of equity.
For an individual colon cancer patient, for example, the issue of high cost is not theoretical, but immediate. There is often a time lag between approval by the U.S. Food and Drug Administration and insurance coverage. Also, although insurance may cover part or all of the costs, some policies have a cap: a maximum amount the policy will pay for a person over a lifetime. Those on Medicare without any other insurance pay 20% of the cost, which can be substantial.
If the cost of your chemotherapy is prohibitive, check whether you qualify for one of the programs that some pharmaceutical companies sponsor to help pay for their drugs. They may even provide them free of charge. Many communities also have such programs. A list of pharmaceutical companies that offer help to patients is available toll free at 1-888-4PPANOW (1-888-477-2669) or at https://www.pparx.org.
For more Alerts and Special Reports, please visit the Prescription Drugs Topic page.
