Cancer care is more exact—and more expensive—than ever. Targeted therapies at the molecular and immunologic levels are increasingly effective and less toxic than cancer treatments of the past, but the cost can be crippling.
According to a new paper in the Annals of Translational Medicine, $115.4 billion was spent on personal healthcare-related to cancer in 2013, and that number is projected to exceed $200 billion by 2020. Fueled by the expense of therapies, drug prices inflated by manufacturing costs, market pressure, and the high cost of research and development, this growing expense has increasingly rested on the shoulders of cancer patients.
According to the report, as the toxicity of treatments declines, a new “financial toxicity” is emerging in the form of higher deductibles, co-insurance, copayments, and out-of-pocket expenses for patients. In addition to patients having decreased productivity at work due to illness, or perhaps even having to stop work, out-of-pocket costs can exceed 20% of a patient’s income and even push them into bankruptcy.
“As cancer drugs become more effective, patients receive them for longer. With increased cost sharing, patients are then responsible for a growing portion of drug costs. Over time, these out-of-pocket costs from rising deductibles, copays, co-insurance, and premiums can add up for some patients to insurmountable debt,” says S. Yousef Zafar, MD, a researcher and medical oncologist at the Duke University School of Medicine and co-author of the paper. “Our studies have suggested that insured patients receiving cancer treatment cut out vacations, spend less on food and clothing, and spend down savings all to help pay for their care.”
Treatment prices are one part of the problem. Before 2000, the average annual price of cancer treatment was $5,000 to $10,000. Now, some medications cost more than $10,000 per month, with the median price of the 13 cancer drugs approved by the FDA as of 2015 reaching $145,000 per year. Biologic and targeted therapies are to blame, despite their physiological benefits to patients. Two such medications alone—added to the chemotherapy cocktail for metastatic colon cancer—raised the tab for six months of treatment by about 285%, according to the report.