Many cancer patients struggle with
out-of-pocket cancer care expenses, with one drug costing nearly $12,000
annually and FDA approved drugs priced over $100,000 a year.
January 15,
2020 - Price tags of life-saving treatments are continuing to
increase, with nearly $150 billion being spent nationally per year for cancer
care, four times more than treatment for other common health conditions,
according to a report from
The Mesothelioma Center.
Sixy-three percent of
cancer patients faced financial struggles following a cancer diagnosis.
Cancer treatment
costs were reported highest among preventable cancers such as lung cancer,
colorectal cancer, breast cancer, and mesothelioma. Specifically, the lifetime
cost of lung cancer was an estimated $282,000 while mesothelioma was a reported
$150,000.
One drug cost
patients nearly $12,000 a year, while 11 of the 12 FDA approved cancer drugs
were priced above $100,000 annually. And in 2015, cancer cost Americans aged 16
to 84 a total of $94 billion in lost earnings.
Furthermore, nearly
20 percent of cancer patients and their families estimated they spent more than
$20,000 each year in total out-of-pocket costs, the Mesothelioma Center
reported.
Out-of-pocket drug
costs forced 12 percent of cancer patients to lower the dose of their
prescription drugs to make them last longer. Skipping or lowering doses of
vital medications puts patient’s health at grave risk.
The hidden cost of
cancer is also a serious hardship. For example, almost half of cancer patients
(49 percent) reported that travel expenses related to treatment was an
additional financial burden.
“People often only
think up to surgery, but post-operative care is where the higher costs are.
Dealing with complications and covering costs of scans, home care and follow-up
treatments such as chemotherapy is when it gets really expensive,” explained
Missy Miller, medical outreach director at The Mesothelioma Center.
Despite the high cost
for these cancer drugs, they aren’t always proven to work. A 2019 study published
in JAMA Network Open showed that only 13 percent of patients
who received checkpoint inhibitors actually benefited from the treatment.
Low-income families,
Americans who are uninsured, and blue collar workers who have medical bills
four times their annual salaries are very unlikely to afford the increased
costs of cancer treatments.
To put this into
perspective, the annual mean wages for the top blue-collar jobs was about
$50,000 in 2018, which is less than the monthly cost of some cancer drugs.
The reported average
monthly income in the US is $3,600 before taxes, a third of the cost of some
chemotherapy and immunotherapy infusions. And a patient with 25 percent
coverage would have month out-of-pocket costs of $2,500 for a cancer drug that
costs $10,000 each month, the report stated. This is almost 70 percent of the
average American’s monthly income.
And these high costs
don’t affect all patients equally.
A separate study published
in the Journal of Oncology Practice found that out of 55,288
patients with breast, lung, and prostate cancer, cost was based more on
geography and the individual provider than patient or disease factors.
Cancer death rates
are approximately 20 percent higher among residents of the poorest US counties.
And eight of the ten states in southern, central, and western regions with the
highest poverty rates fell in the top ten percent for cancer death rate, according to
the CDC.
Millions of Americans
face affordability issues, and financial hardship is common among patients who
require prescription drugs. But value-based care is vital for payers to push
members toward higher medication adherence by recognizing these various
hardships, such as cost.
In April of last year,
the national Oncology Model of Care (OMOC) program was launched for
Humana Medicare Advantage to boost experience for patients with cancer
diagnoses through affordable care.
Numerous factors are
taken into consideration when quality and costs are determined, including
inpatient admissions, emergency room visits, medical and pharmacy drugs,
laboratory and pathology services, and radiology.
The OMOC is Humana’s
fourth specialty-care payment model which will further past efforts to deliver
value-based, affordable healthcare to its members. The model will ensure more
personal time with health professionals, personalized care that is tailored to
each individual’s health situation, and access to proactive health screenings.
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