The Cost Burden of Blood Cancer Treatments

October 29, 2019
Briana Contreras

New study shows that although costly, more effective treatments increase survival rates in Medicare patients.

Older patients’ survival rates with blood cancers continues to improve as more effective and fewer toxic therapies are introduced, according to a press release.

However, these lifesaving treatments often are expensive, and many cancer patients face financial burdens caused by ever-increasing healthcare costs.

Research found in a recent

conducted by The Leukemia & Lymphoma Society (LLS) reveals 59% of surviving blood cancer patients enrolled in traditional Medicare do not begin active treatment within three months of their diagnosis.

There are many factors likely to contribute to these delays, however, the LLS believes high costs could be a key driving factor in these patients’ behavior.

The study “The Cost Burden of Blood Cancer Care in Medicare,” conducted by LLS from Milliman, an independent and national law firm, identifies factors driving costs to the healthcare system and impacting patients. It also expands more on the out-of-pocket cost burden associated with cancer treatment for blood cancer patients.

According to Brian Connell, executive director of federal affairs at LLS, these costs vary depending on factors such as blood cancer type, demographics, selected treatments as well as insurance coverage and benefit design. This analysis focused on understanding the impact of these factors and the drivers of health care costs for newly diagnosed 

“In addition to the emotional impact of dealing with a blood cancer, patients and families often face extraordinary costs in the first year after diagnosis and beyond,” says Louis J. DeGennaro, PhD, CEO and president of LLS. “The Leukemia & Lymphoma Society hopes that the findings from this new study will prompt payers, providers, patient advocates and policymakers to work together to address the financial burdens for patients.”

Related: Five Reasons for Optimism in Blood Cancer Treatments

Results of a study LLS previously commissioned from Milliman, last October, looked at the cost burden for blood cancer patients covered by commercial insurance plans. The study found that the average costs of treating blood cancer patients are higher than those of treating patients with other types of cancers.

Patient out-of-pocket costs for blood cancer care averaged more than $17,000 in the first year and remain to average thousands per year with assistance by an insurance plan, according to Connell.

For example, recent findings show some traditional Medicare lymphoma patients who receive anti-cancer therapy through infusions experienced out-of-pocket costs of more than $19,000 in their first year. For some acute leukemia patients, enrolled in traditional Medicare and on infused anti-cancer therapy, out-of-pocket costs were more than $16,000 in the same period.

Connell says patients with blood cancer continue to encounter high-cost sharing two to three years after their diagnosis.

Although supplemental coverage lowers cost-sharing for some patients on infused therapies, Kaiser Family Foundation has reported that one of four Medicare beneficiaries has no such coverage.

According to findings, after two years patients newly diagnosed with multiple myeloma in traditional Medicare incurred cumulative out-of-pocket costs averaging nearly $24,000. After three years, those with chronic leukemia had the lowest cumulative out-of-pocket costs among all blood cancer patients, averaging more than $15,000. While this figure is less than the cumulative expenses incurred by multiple myeloma patients and others affected by blood cancer, out-of-pocket costs such as these pose a financial burden for many patients.

“Everyone in healthcare needs to understand what is driving spending and what barriers are standing between patients and lifesaving care,” Connell says. “LLS believes that it is important for all stakeholders-healthcare executives, payers, policymakers, drug makers-to understand the impact of these costs on the Medicare system and on patients, caregivers and families. Insurance programs like Medicare too often respond to increased treatment costs by erecting barriers to care, such as increasing cost-sharing and limiting access to certain cancer centers and providers, that lower cost at the expense of patient access.”

He adds relatively modest cost-sharing can even deter patients from accessing care they need.

“Both commercial and Medicare Advantage plans need to reassess their cost-sharing structures and make the changes necessary to ensure that out-of-pocket costs aren’t preventing patients from accessing care they need,” Connell says

Briana Contreras is associate editor of Managed Healthcare Executive

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