Even a Presidential Panel Worries about Cost

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

MARCH 23, 2018

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Even the President's Panel on Cancer has issued a warning about the high cost of cancer drugs. Their report includes the dire prediction that drug costs are making it harder/impossible for some people to access their needed care. If you can't pay for the medication, you aren't getting the treatment. I have written a number of times about this issue, and I think I should be happier that concern is being expressed at the very top, or close to the very top, of our government. However, in spite of the escalating noise about this, I haven't seen any evidence of prices coming down.

Instead I hear weekly from or about patients who have astronomical co-pays. The usual scenario is something like this: There is some evidence of progression or too difficult side effects or another reason why a treatment drug needs to be changed. If the change is to a drug that is infused (meaning an IV) or injected, any sticker shock does not come until the bill eventually reaches the patient. The much more common experience is that the drug is an oral medication (meaning pills), and the patient goes naively to the pharmacy to fill the new prescription. It is then that the pharmacist announces a co-pay of (and, yes, this is real; I am not making it up) of $5000 or $9000 for a month's supply. Imagine the panic: I can't possibly afford that, but my cancer doctor has just told me this is the medicine that I need. Can I charge it? Is my credit card going to take this big a charge? How will I ever pay it and what about next month and the month after that?

Many of us believe that the cost of drugs should be part of the conversation between the doctor and the patient. That rarely happens. To be fair, it is the rare oncologist who actually knows the cost of a drug, let alone what a particular person's insurance will cover. But it ought to be possible to discuss the possibility that a new drug is going to be expensive and let's check it out before we decide on a plan. In many cases, there is an older, less expensive alternative.

From Web MD comes this article.

Presidential Panel: Costly Cancer Drugs Harm Care

"Financial toxicity" caused by high cancer drug prices is harming people's ability to fight the dreaded disease, a new report from the President's Cancer Panel warns.

The report, released Tuesday, argues that urgent action is needed to stem the growing price tags associated with new cancer drugs, particularly if the price doesn't match the amount of benefit the drug offers.

"Drug costs are accelerating far faster than costs for other components of care, which, together, can result in a significant financial burden on patients and their families," the three-member panel wrote. "When financial resources are strained, patients are less likely to follow treatment regimens, potentially worsening health outcomes these drugs are intended to improve."

The panel recommends a series of actions to minimize the impact of drug costs on patients while also promoting value-based pricing of newer drugs.