Cancer Drug Costs
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
JUNE 16, 2017
This is a companion piece to yesterday's entry about doctors not discussing prognosis with their patients. Not a surprise, but they don't often discuss costs either. In my mind, the two issues are closely related. We all know that many new cancer drugs are hugely expensive, and that many people have very high deductibles or co-pays. It is not unusual for a patient to be asked to spend a couple thousand dollars/month/cycle towards the total cost of a drug. Lots of people can't do that.
As someone considers a new treatment, it seems only fair to have full information both about how useful the drug is likely to be (e.g. does it have an 80% chance or a 5% chance of extending life and how much longer might it be? Some highly touted new treatments actually extend life for a week.) If I am going to dig deep into my savings to cover a co-pay, it may matter how helpful the drug may be for me.
To be fair, most oncologists don't know the cost of the drugs they are prescribing. Not only are the prices not instantly available online, but different insurances have different policies, so each situation must be explored. What, I think, doctors should do is bring this issue into the conversation. Let's consider the drug, be honest about what it might do, and think about we can find out the cost. Then it really is a shared decision between the doctor and the patient.
Few Doctors Discuss Cancer Costs With Patients, Study Finds
Most doctors did not discuss the cost of cancer treatment with patients, spent less than two minutes on it when they did, and usually did so only after patients brought it up, a study that taped hundreds of visits at several large hospitals finds.
Cancer patients are three times more likely to declare bankruptcy than people without cancer are, but many doctors are not having the conversations that might help prevent this and sometimes don't know the cost themselves, the results suggest.
"That would not occur in any other industry I can think of" where a service or product is sold, said the study leader, Dr. Rahma Warsame of the Mayo Clinic.
Results were released Wednesday by the American Society of Clinical Oncology and will be discussed next month at its annual meeting in Chicago.
The study has some limitations — it's not nationwide, and it includes newly diagnosed patients, where cost is most likely to come up, as well as others further along in treatment who may have discussed this earlier.
But the larger point is clear, Warsame said: The "financial toxicity" of treatments that can cost more than $100,000 a year is growing, and talks about that aren't happening enough.
"I've had people say 'no' to really life-extending therapies" because of worries about bankrupting their family, she said.