[Ip-health] Sticker shock a side effect of cancer remedies

[Joana Ramos]

Notice that no mention is made of the need to do anything to control the
costs of cancer drugs, which is posited as just a personal concern,
election year not withstanding. Big Pharma has done its PR work well......

Joana
--------------- original article--------------------
http://www.msnbc.msn.com/id/23783216/
Copied as fair use from MSNBC

Sticker shock a side effect of cancer remedies
As chemo prices rise, doctors get first guidelines on discussing
affordability

Retiree Helen Geiger of Whiting, N.J., has multiple myeloma, a blood
cancer. She is well-insured, but had to scramble to find the money to
cover the high cost of her anti-cancer pills when her coverage was changed.


WASHINGTON - You=92ve just been diagnosed with cancer, and the doctor is
discussing treatment options. Should the cost be a deciding factor?

Chemotherapy costs are rising so dramatically that later this year,
oncologists will get their first guidelines on how to have a straight
talk with patients about the affordability of treatment choices, a topic
too often sidestepped.

=93These are awkward discussions,=94 says Dr. Allen Lichter of the American
Society of Clinical Oncology, which is writing the guidelines. =93At least
we can bring this out in the open.=94


It=92s a particular issue for patients whose cancer can=92t be cured but wh=
o
are seeking both the longest possible survival and the best quality of
life =97 and may be acutely aware that gaining precious months could mean
bankrupting their families.

The prices can be staggering. Consider: There are two equally effective
options to battle metastatic colon cancer, the kind spreading through
the body =97 but one costs $60,000 more than the other, says Dr. Leonard
Saltz of Memorial Sloan-Kettering Cancer Center.

What=92s the difference? The cheaper one, irinotecan, causes hair loss
that makes it impossible for people trying to keep a job to hide their
cancer treatment, he explains. The pricier oxaliplatin can cause nerve
damage in hands and feet that might make it a worse option for, say, a
musician or computer worker.

Saltz offers a tougher example: A drug for pancreatic cancer =97 an
especially deadly cancer with few treatment options =97 can cost $4,000 a
month. Yet while Tarceva has offered some people remarkable help,
research suggests that extra survival on average is a few weeks.

=93Is it a good investment, a high-risk investment, or buying a lottery
ticket?=94 is how Saltz puts these choices.

Drug prices are a growing issue for every disease, especially for people
who are uninsured. But cancer sticker shock is hitting hard now, as a
list of more advanced biotech drugs have made treatment rounds costing
$100,000, or even more, no longer a rarity. Also, patients are living
longer, good news but meaning they need treatment for longer periods.
The cost of cancer care is rising 15 percent a year, Lichter notes.

Make no mistake: Some of these newer drugs have greatly helped some
patients =97 Gleevec, for example, has revolutionized care for a type of
leukemia =97 and the prices reflect manufacturers=92 years of research and
development investment.

Also, drug companies do donate a certain amount of medication to
prescription-assistance programs that provide them for free to patients
who otherwise couldn=92t pay. Since 2005, nearly 5 million people =97 cance=
r
patients and people with other diseases =97 have been matched to such
programs through the drug industry=92s =93Partnership for Prescription
Assistance.=94

But few patients get a Gleevec-style home run, and there=92s very little
research that directly compares competing treatments to guide cancer
patients on which might offer the best shot at survival for the money.

=93As long as a therapy provides a benefit, it will tend to be offered to
patients. Whether it=92s a small benefit or a moderate benefit, it may be
offered with the same level of enthusiasm,=94 says Dr. Neal J. Meropol of
Philadelphia=92s Fox Chase Cancer Center, who is leading the panel writing
ASCO=92s new guideline on how to weigh treatment costs.

The idea: treat cost essentially as another side effect to weigh in
choosing a therapy. Meropol has watched patients do those calculations
on their own, like the colon cancer patient who asked to switch from
oral chemo to cheaper but more laborious intravenous chemo, or the woman
who refused a pricey anti-nausea drug that would make her chemo more
bearable.

Even if doctors want to discuss cost, they may not know it =97 it=92s not
included in treatment standards. At a meeting of the standard-setting
National Comprehensive Care Network earlier this month,
Sloan-Kettering=92s Saltz and other doctors urged adding chemo prices to
those treatment guidelines.

=93If there=92s a need to spend it, let=92s talk about it. If we can do it
just as well less expensively, I think doctors should know that and be
able to make a decision,=94 Saltz says.

Even the well-insured are feeling the bite as patients are having to
shoulder a higher portion of the bill.

When Medicare began its Part D prescription coverage, retiree Helen
Geiger of Whiting, N.J., paid for a premium plan and put it to good use
when she was diagnosed with multiple myeloma, a blood cancer. She said
the plan listed the cost of her dose of Thalomid at $5,500 a month but
her copay was $60 a month.

In renewing the prescription plan last year, the 71-year-old Geiger
didn=92t notice that Thalomid coverage had been changed. It now was
classified a specialty drug, costing a $1,051 monthly copay that she
couldn=92t afford. She went several months without the anti-cancer pills,
as her doctors at Philadelphia=92s Fox Chase Cancer Center and her family
appealed to the insurer and then scoured charities in hopes of finding
her free or cheaper drug.

=93You don=92t need this kind of stress when you=92re sick,=94 says Geiger,=
 who
finally stumbled onto a prescription assistance program that provided
her free medicine.

---------------
Joana Ramos, MSW
Cancer Resources & Advocacy
Seattle WA USA
+1-206-229-2420
http://ramoslink.info/
www.bmtbasics.org