Cancer-Drug Costs Rise, Leaving Even Insured Patients with Financial Burden
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Research suggests that cancer may not be a genetic disorder. (Health 1+1 / The Epoch Times) |
Emerging Patterns in Cancer Data
For more than seven decades (CDC), cancer has remained among the top two leading causes of death. Well over one-third of the U.S. population will confront a cancer diagnosis during their lifetime, according to National Cancer Institute estimates.‘Early-Onset Cancer Epidemic’
Research published in 2022 points to an “early-onset cancer epidemic.” Some evidence suggests a 79.1 percent global increase in early-onset cancers from 1990 to 2019 and a nearly 30 percent rise in related deaths.The Rising Financial Toll
As more cancer diagnoses loom over younger, working-age Americans, those affected face financial problems due to the rising costs of life-saving treatments.Forty-seven percent of over 1,200 cancer patients and survivors surveyed have accrued debt due to their cancer treatment, with 49 percent carrying a burden exceeding $5,000. As many as 69 percent have been grappling with this debt for over a year, and more than a third (35 percent) have been facing cancer-related debt for three years or longer.
Almost all (98 percent) of these respondents were insured when the debt was incurred, with high-deductible health plans without a health savings account being the most common coverage (34 percent).
The findings suggest that those burdened with cancer-related medical debt are three times more likely to fall behind on recommended cancer screenings (18 percent versus 5 percent). Twenty-seven percent have gone without adequate food, while another 25 percent have been forced to skip or delay essential care due to the crippling debt.
The median price for treatment for oncology drugs averages $257,000 per year—3.7 times higher than that of non-oncology drugs. Compounding the issue, the average inflation-adjusted launch price for oral cancer drugs increased by over 25 percent between 2017 and 2022.
Health Care System’s Role in Drug Pricing
The overall health care system is to blame for exorbitant drug prices, Pavani Rangachari, a professor of health care administration and public health at the University of New Haven, told The Epoch Times.The lack of price regulation and negotiations in the U.S. system allows pharmaceutical companies to enjoy “free rein” in setting prices, even for drugs with minimal benefits in prolonging life, such as those extending survival by only three or four months, she added. Patients could accumulate over $150,000 in costs for certain cancer drugs within that short timeframe, Ms. Rangachari noted.
While the high costs associated with drug development from “bench to bedside” contribute to the problem, pharmaceutical companies essentially hold monopolies due to patent protection, enabling them to maximize profits, she added.
The companies can also partner with providers and physicians and incentivize them to continue prescribing expensive drugs, Ms. Rangachari said.
A Medical System in Need of Reform
The problem with expensive cancer drugs is a systemic issue that demands government intervention through value-based purchasing models, Ms. Rangachari said.These alternative payment systems allow states to negotiate lower drug costs with manufacturers, who should also be required to demonstrate the cost-effectiveness of their cancer treatments, as is the practice in other developed nations through value-based pricing tied to health outcomes and quality-adjusted life years.
However, the burden does not solely rest on pharmaceutical companies. All stakeholders, including cancer centers, must increase transparency for cancer patients, as the financial hardship for them extends beyond just medical costs to indirect factors like lost productivity.
Despite the current system’s flaws, some cancer centers have begun screening for financial distress among patients and offering services to help them. “That can make a big difference,” Ms. Rangachari said. Insurers can alleviate the strain on patients by reducing prior authorization requirements, considering off-label drug uses, minimizing coverage restrictions, and lowering out-of-pocket maximums, she added.
Ms. Rangachari emphasized the unsustainability of the current system, with insurers potentially being the biggest losers due to premium pricing issues stemming from the high variability in drug costs. She questioned how insurers could set premiums amidst pharmaceuticals’ unpredictable pricing, highlighting the risk of high expenses burdening patients unfairly.
There will likely be pushback from powerful entities as the Centers for Medicare & Medicaid Services (CMS) implements value-based pricing, Ms. Rangachari noted. “So the government has to gear up for a big fight.”
Reposted from: theepochtimes.com/health/cancer-drug-costs-skyrocket-leaving-even-insured-patients-in-financial-ruin-5666035
Related: Top 10 Cancer Fighting Supplements
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