'Financial toxicity' of cancer

New reports point to skyrocketing drug costs, increasing patient burden

Global spending on cancer drugs is closing in on $100 billion, according to a new report issued Tuesday by a major drug research institute.

The IMS Institute for Healthcare Informatics announced that global spending on cancer drugs – including those used for supportive care – reached $91 billion in 2013, up from $71 billion in 2008. The U.S. dominates oncology spending with 41 percent of the cancer treatment pie. That translated to $37.2 billion spent in 2013. 

According to the report, recently approved oncology treatments (i.e., “branded” drugs), now run about $10,000 a month in the U.S., up from an average cost of $5,000 a month ten years ago. In addition, the report found that more costs are being shifted to patients with the increasing burden “linked to declining therapeutic adherence potentially resulting in drug discontinuation and higher overall total costs of care.”

These findings piggyback onto another IMS Institute study issued mid-April that focused on consumers’ use of health care, including visits to the doctor, hospital admissions, and prescription drug use.

All of the above went up in 2013 thanks to an improved economy, but so did the costs of prescription drugs for cancer patients.

While nearly 60 percent of all retail prescriptions carry an average out-of-pocket cost of $5 or less, the report said prices for specialty drugs, particularly those used for diseases like cancer and hepatitis C, were continuing to burgeon. Thirty percent of total patient out-of-pocket costs relate to just 2.3 percent of prescriptions. 

“These reports and the media coverage around them highlight the fact that drug costs are again soaring, largely fueled by the rising costs of specialty drugs with new cancer drugs leading the pack,” said Fred Hutch’s Dr. Gary Lyman, co-director of the Hutchinson Institute for Cancer Outcomes Research (HICOR). “For many, the indirect and out-of-pocket expenses of cancer care are more than they can handle leading to interruption or even cessation of potentially life-saving treatment. “

Gary Lyman
“For many, the indirect and out-of-pocket expenses of cancer care are more than they can handle leading to interruption or even cessation of potentially lifesaving treatment,“ said Fred Hutch’s Dr. Gary Lyman, co-director of the Hutchinson Institute for Cancer Outcomes Research (HICOR). Bo Jungmayer / Fred Hutch

Burden of cancer care costs

Lyman said the ever-rising cost of cancer care is making it increasingly “toxic.”

“It is important to be aware not only of the physical toxicity but also the financial toxicity of cancer treatments,” Lyman said, pointing to the enormous economic burden cancer and cancer treatment places on patients and their families.

A recent Fred Hutch study led by HICOR director Dr. Scott Ramsey determined that people diagnosed with cancer are two-and-a-half times more likely to declare bankruptcy than those without cancer. 

Fred Hutch created HICOR to help reduce the cost and improve the effectiveness of cancer prevention, treatment, and therapy.

“It is because of the unsustainable rise in the costs of cancer care, including that related to drugs and aggressive and often unnecessary imaging procedures, that HICOR has taken on the charge,” said Lyman.

HICOR is tasked with evaluating current practice patterns, figuring out what works and what doesn’t, and then working with its partners – insurance companies, providers, health systems, patient groups, and others – to develop workable strategies for improving the quality of cancer patient care while bringing down the costs.

 “We’re trying to improve the overall value of cancer care,” said Lyman.

Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has also written extensively about health issues for nbcnews.com, TODAY.com, CNN.com, MSN.com, Columns, and several other publications. She also writes the breast cancer blog, doublewhammied.com. Reach her at dmapes@fredhutch.org.

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