The cost of cancer drugs is the top challenge in U.S. cancer programs, according to a new survey.
The Association of Community Cancer Centers (ACCC) seventh annual Trends in Cancer Programs survey shows that the costs of cancer drugs was named the top challenge by 2016 survey respondents (83%) — nearly double (45%) the number of respondents from last year’s survey.
“Nearly all healthcare professionals reported the cost of cancer care drugs is the top challenge and concern, followed by reimbursement of patient care services like financial advocacy and nurse navigation, which was the leading concern cited in the 2015 survey,” says ACCC President Jennie R. Crews, MD, MMM, FACP.
Yet, according to the survey, respondents recognize that drug costs are only one driver of the escalating cost of care, and that the issue is nuanced. “Affordability of care requires two conversations: total cost of care to the system and then the affordability for the patient,” said one survey respondent.
In another continuing trend, the survey found that lack of reimbursement for supportive care services, such as patient navigation, survivorship care planning, and financial counseling, which are key elements of patient-centered care, remains a critical issue (66%).
“The cost of cancer care drugs is motivating more healthcare professionals to provide patients with financial assistance by helping them access pharmaceutical drug replacement programs [77%] and offering the services of financial advocates or counselors [64%],” Crews says.
The survey found that only 39% of respondents reported financial advocates met with all patients to discuss insurance options and cost care.
To help expand the knowledge and capabilities of providers, the ACCC Financial Advocacy Network provides tools and resources such as the 2016 Patient Assistance & Reimbursement Guide and the new Patient Assistance App.
“This mobile device app gives financial advocates easy access to payment assistance and reimbursement programs,” Crews says.
While ACCC member cancer programs have made great strides in advancing patient-centered care, it’s clear that payer policies are lagging behind, according to Crews.
“Reimbursement for these services is especially critical as we transition to new models of cancer care delivery such as the Oncology Care Model [OCM] and the Merit-Based Incentive Payment System [MIPS].”
Survey respondents cited the need for increased transparency in commercial insurance policies so that patients can readily understand what services plans do—and do not—cover (64%).
ACCC has put together a cost transparency group to determine how to provide education and assistance to patients who have been prescribed high-cost chemotherapies or immunotherapies.
Finally, respondents cited a critical need for “physicians and mid-level providers to focus on direct patient care—not paperwork” (55%).