Cancer strikes fear in the heart of anyone, no matter what their age. How cancer treatments affect your body can be scary, but it can also have huge financial ramifications for you and your family as well. The treatments given to combat cancer have increased the life expectancy and outcomes for many patients, but this increase comes at a cost many find difficult to bear.
The Financial Cost of Treatment
Cancer drugs are continually being released and the prices are continually going up. Between 2009 and 2014, the cancer drugs that were launched were priced at $100,000 or more per patient for a year of treatment. This is not the highest, however. Kymriah, which treats adolescent and young adult acute lymphoblastic leukemia, has a price of $475,000 for a year of treatment, which is exorbitant.
One study led by the Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center showed the monthly cost of cancer drugs had climbed 100 times in the period of time between 1965 to 2016. Is it any wonder patients are choosing to not fill prescriptions for these medications or are not taking them as directed? The cost, even with insurance, is more than many can bear without throwing their family into bankruptcy, which occurs quite often in families who are dealing or have dealt with a medical crisis.
Why Are They So Expensive?
Many different factors come together to create the reason for this. The amount of research and development, as well as testing, that is completed on each drug before it is even brought before the FDA is very expensive. Additionally, due to the serious nature of cancer, there is a certain medication protocol which is followed, depending upon the type of cancer diagnosed. Often the medications are used in combination therapy, which means an expensive drug is combined with other expensive drugs and the cost becomes more than you can imagine.
Another issue has the government, medical community, and citizens up in arms. The pharmaceutical companies are not representative of a free-market system where there are traditional checks and balances to keep the prices lower.[1] They are able to price the medications at any amount they choose. Most pharmaceutical companies report net profits higher than those of a Fortune 500 company. It is obvious they are making money even though it is expensive to bring these medications to the market.
This does not even begin to cover incentives paid back by pharmaceutical companies in forms of rebates to those selling the drugs. Pharmaceutical Benefit Managers make a lot of money on rebates.
The United States has seen a great increase in the cost of drugs while as some of the same medications can be purchased in other parts of the world for an average of 41% less. Some patients choose to go across the borders to get medications, even though they may not be as regulated as they are in the US.
Another reason it is so expensive to treat cancer is the duration of treatments. Cancer treatment are going longer than treatment in the past. The cancer drugs manufactured today are more tolerable and they work better. This has changed the delivery process and the time one can tolerate the treatments.
What Can Be Done About These High Prices?
The average cancer patient pays $4000 a year for their cancer drugs, and this is after insurance. With the prices continuing to rise, this out-of-pocket will be sure to rise as well. There are several different ways to combat this. The first is to find ways to align the cost with the projected value to the patient. For example, is this medication going to put them into remission? Is it just going to give them a few extra days or months? Is it possible it may increase their life but drastically decrease its quality?
The second thought to reducing high prices is making the market more competitive. Competition is limited in the pharmaceutical world due to drug patents, which keeps the drugs from moving to the generic market for 20 years from the beginning of the testing phase. To bring the cost down, some experts believe either drug patents should be banned, bought by the federal government who would license them to other pharmaceutical companies, or the federal government should fund research and development for new drugs themselves.
There are also ways to negotiate prices. Insurance companies have the power to negotiate these prices to a more reasonable amount. For employers that choose to self-insure, Curus through its Curus Health Navigator program has found a way to help limit the cost exposure for those companies and thus the employees that may have to pay for them. Sometimes it’s all about limiting the middleman, or finding someone to negotiate on behalf of a group. It does not reduce costs to all Americans, but it certainly can help those who choose to take advantage of those programs available to them.
Whatever the solution, it is certain it is going to take some time and some compromise. For now, it is important the healthcare team be upfront and honest about the cost of treatment with a patient. Having an open conversation about the financial side of cancer treatment as well as the quality of the hopefully prolonged life can allow them to ensure the patient takes their medications as needed and gets the resources and the help they need to do so or make educated decisions. Curus members with complex care issues like cancer have the advantage of someone unbiased to go over all the options and ensure a patient gets both the care they need and at costs worth bearing.
