Worried about treatment costs? You are not alone

by Linda House and Lauren Barnes, Senior Vice President, Avalere

Until recently, patients being treated for cancer primarily received cancer drugs through an intravenous infusion, which meant they had to receive treatment in an oncology office or a medical setting. Anti-cancer medications that can be taken by mouth are a relatively new type of cancer treatment. Because these medications can be taken at home, they can save patients valuable time and energy. Yet research has shown not all patients complete their treatment regimens, which can reduce a treatment’s effectiveness.

In 2010, Avalere Health conducted an analysis on behalf of the Community Oncology Alliance to get a better understanding of what issues prevent patients from adhering to oral anti-cancer therapy. Our study found patients were primarily abandoning treatment due to two key factors: high costs and higher prescription activity.

Let’s first explore the high costs associated with oral therapies.  Because these options are covered differently than infusions by insurers, sometimes patients have to enter into a cost-sharing situation, meaning the cost for treatment is ‘shared’ by both the patient and the insurance company.  Think about going to the pharmacy and the amount one might pay to pick up a prescription. The Avalere study found the situation where patients having to ‘share’ over $500 were four times more likely to stop therapy than patients whose ‘share’ was $100 or less. Patients covered by Medicare, which tends to require higher patient cost-sharing for these drugs than most commercial insurance plans, were also more likely to abandon treatment.

The second issue deals with higher prescription activity.  This speaks to the number of prescriptions a patient has to fill.  It should be noted that patients who fill more than five prescriptions for non-cancer medicines in a month abandoned treatment at a higher rate than patients with no pharmaceutical claims. This finding raises a number of questions about underlying causes including cost of therapy, ability to secure required resources, patients feeling overwhelmed, etc.

If you find yourself needing support as you face these and other issues, reach out to others as you are making your initial treatment decision and if you find yourself in need of assistance as you move through your cancer journey.  The Cancer Support Community has free resources specific to these needs in their Frankly Speaking About Cancer: Cost of Care program and also their Open to Options treatment decision counseling program.  Additionally, your local pharmacist and/or patient navigator can help patients identify ways to save money without sacrificing quality of care, including helping patients identify and apply to for prescription assistance programs.

For more information on this research project and its funding, please visit www.communityoncology.org/oral-oncolytics-study-funding-information. For more information on Avalere Health, go to www.avalerehealth.net.


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