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By Richard C. Frank, MD
From diagnosis and treatment to remission and survival
Thursday, October 4, 2012
I rarely give my patients prescriptions for cancer-fighting medicines. I know there is no way they can just bring it to the local pharmacy and come out with a month’s supply of pills costing $10,000. I no longer assume that I will be able to treat my patients with the recommended infusional therapies for their cancer: some of the newer treatments can cost over $100,000. Clearly, the good old days of going to the doctor, getting a prescription or injection, and having insurance pick up the tab with no hassles are long, long gone when it comes to treating cancer. It is now a reality that right after doctor and patient confront the shock of cancer, discuss its prognosis and the risks and benefits of treatment and all that those entail, they must immediately tackle together the question of how the treatment will be paid for. Every cancer patient worries, “How can I afford this?” Every oncologist has to fill out forms, petition insurance companies, clear treatments with their hospitals and business offices, and assist patients with finding strategies to pay for life saving care. Why is this so? How should patients cope with this situation?
There is no doubt that advances in cancer research are leading to better ways to treat cancer and improved survivals in many cases. A recent report from the American Association of Cancer Research (AACR) highlights these many scientific advances and the new drugs resulting from them. But research is expensive. The National Institutes of Health has an annual budget of $30 billion, of which $5 billion is allotted to the National Cancer Institute to fund cancer research. But this money all goes to fund not-for-profit research centers, mainly those that are laboratory based. The pharmaceutical and biotech industries are largely responsible for funding the clinical trials that test new drugs in cancer patients and this costs many billions of dollars as well.
As a result, the new cancer drugs are extremely expensive. Some examples include the new breast cancer drug Perjeta, which costs $188,000 for a six-month course, and the melanoma drug Yervoy, weighing in at $120,000 for four doses. As pointed out in the September 3rd issue of Newsweek, in an article entitled, “How Much Would You Pay For Three More Months of Life?” we could accept these exorbitant prices if the drugs were cures. Disappointingly, they extend life anywhere from two to six months on average. Yet, some individuals may have extraordinary responses and the first FDA approval of a new drug supports testing for other types and stages of cancer where they may be even more potent.
I do not have a solution to the high costs of new cancer medicines but I do know that patients want to receive them, as they represent the best hope, and oncologists want their patients to get them. Here are some of the strategies we use to help patients access costly cancer drugs:
1. Have your cancer providers submit prescriptions for oral cancer drugs to specialty pharmacies that work with your insurance coverage to get the best price. Some of the organizations to work with are:
· Advanced Care Scripts (877-985-6337)
· The chain drugstores such as Walgreens and CVS also have specialty pharmacies.
2. Contact the Chronic Disease Fund (877-968-7233, email: email@example.com) and the Partnership for Prescription Assistance (888-477-2669) for financial assistance to pay for medicines.
3. Have your cancer providers contact the company that makes the cancer drug you need to see if you qualify for free drugs based on financial statements that you are required to submit.
4. Contact patient advocacy groups such as the Leukemia & Lymphoma Society, American Cancer Society, Susan G. Komen for the Cure, and other disease-specific patient advocacy groups to see if they can help.
Posted by: Richard C. Frank, MD at 6:32 am
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