The cost of cancer has increased substantially over the years and is continuing to trend upward. During a session at the Oncology Nurse Advisor Navigation Summit, Yousuf Zafar, MD, MHS, an associate professor of medicine and public policy at Duke Cancer Institute, gave some facts and figures on cancer costs and how these are impacting patient well-being.
Zafar gave examples of cancer drug cost increases: Between 2007 and 2014, prices of imatinib 400 mg increased by 158%, erlotinib 100 mg by 91%, and dasatinib 500 mg by 130% (according to a 2014 report from Bloomberg News). He said that on top of rising drug prices, insurance is also more expensive, having increased 40% since 1999, with worker earnings increasing 50% since that time, premiums increasing 182%, and worker contribution to premiums rising 196% (according to a 2013 Kaiser report).
In 2014, the average patient cost for oral therapies was $3,033 compared to $7,040 for IV medications (according to a 2016 IMS Institute report). Zafar said patients with cancer are at 2.65 times the risk of declaring bankruptcy (according to a 2013 Health Affairs report).
He stressed that extreme financial distress and greater risk of mortality because of disease contribute to patient well-being, health-related quality of life, and quality of care.
Patients report foregoing vacations (68%), cutting grocery expenses (46%), and depleting their savings (46%) because of costs associated with cancer (2013 study by Zafar et al.). In another study, 50% said they were willing to declare bankruptcy, 39% were willing to sell their home, and 73% were willing to spend less on food and clothing (in-press study by Chino et al.).
What does all of this mean? An intervention is needed from all healthcare stakeholders, including manufacturers, government, insurers, and health systems, Zafar said.
According to a study by Zafar et al. (published in the American Journal of Managed Care), 52% of patients reported wanting to discuss costs with oncologists, yet only 19% reported actually having this discussion. In the study, Zafar and coauthors reported the following ways to reduce costs for patients:
- Refer to financial assistance (53%)
- Provider appeal to insurance company (25%)
- Switch patient to less expensive drug (19%)
- Change tests or decrease frequency of tests (13%)
- Decrease frequency of patient visits (6%).