Cancer Treatment or Buy Groceries??

  1. Cancer treatment can be very expensive and in addition to the physical side effects, the financial side effects can sometimes be more devastating.

    Cancer Treatment or Buy Groceries??

    What do you think of this?

    "Urgent action must be taken to address the dramatic rise of cancer drug prices and to better align prices with value, according to a report released today by the President's Cancer Panel. The Panel's report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment, finds that while some cancer drugs have indeed been transformative, and may warrant prices that reflect their value, many new drugs do not provide benefits commensurate with their prices. The Panel concludes that stakeholders across the cancer enterprise-including drug developers and manufacturers, policy makers, government and private payers, healthcare institutions and systems, providers, and patients themselves-must work together to maximize the value and affordability of cancer drug treatment and to support investments in science and research that drive future innovations."

    So...how do we do we make cancer medications more affordable?

    The American Cancer Society states; "Cancer is one of the leading causes of death and disease in the U.S. The American Cancer Society (ACS) estimates that roughly 1.7 million new cases of cancer will be diagnosed in the U.S. in 20171 and more than 15 million Americans living today have a cancer history."

    Almost all of us know of someone that has had or does have cancer. Many forms of cancer that were incurable now show long survival rates. However, what if you or a loved one is diagnosed with a cancer that is treatable but only by a very costly means? What do you do? Why are these meds so expensive?

    An article from the Journal of Oncology Practice details the reasons for the high cost of cancer medications:

    "First, pharmaceutical companies use a variety of strategies to delay or discourage competition by generic companies, for example "pay-for-delay" and "approved generics.

    Second, as part of the Medicare Reform Act of 2003, and influenced by the pharmaceutical lobby, legislation forbade Medicare to negotiate drug prices. This, together with the Medicare expansion in 2006 to include prescription drug benefits, resulted in a financial bonanza to companies, clearly charted by the skyrocketing profits since 2006.

    Third, the Patient-Centered Outcomes Research Institute (PCORI), which evaluates treatments for coverage by federal programs, is prevented from considering cost comparisons and cost effectiveness in its recommendations. Such mechanisms, which emphasize value and price, rebalance the legitimacy of the purchaser and patient perspectives by diminishing their position as passive price takers.

    Fourth, US laws forbid the importation of prescription medicines from abroad, even for personal purchases. The purported reason (supported by the pharmaceutical lobby) is patient safety.18 However, in the latest estimates of the Canadian government's Patented Medicine Prices Review Board, as of 2011, US consumers pay 100% more for patented drugs than elsewhere."

    The President's Cancer Panel concludes; "that when it comes to defining the value of cancer drugs, patients' benefit must be the central focus. When patients' finances are strained, they are less likely to follow treatment regimens, potentially worsening health outcomes the drugs are intended to improve. The term "financial toxicity" describes the negative impact of cancer care costs on patients' well-being. Like medical toxicities caused by cancer treatment, financial toxicity can impose a significant burden on cancer patients. Rapidly rising spending on cancer drugs is unprecedented and cannot be ignored, and that public-private collaboration is critical to ensure that patients receive high-quality cancer treatment and experience the best possible health outcomes without financial toxicity."

    Some of the suggestions from the Panel include:

    • Enable communication about cancer treatment options and include information about cost
    • Stimulate generic and biosimilar competition
    • Ensure adequate resources for the FDA
    • Invest in biomedical research

    So, where do our patients stand? Its seemingly up to us, as nurses to provide some of this education. Its not enough that providers and physicians prescribe, but we must all be mindful of the cost.
    Last edit by Joe V on Jun 14
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    20 Comments

  3. by   Kitiger
    Quote from traumaRUs

    "Some of the suggestions from the Panel include:

    •Enable communication about cancer treatment options and include information about cost
    Simulate generic and biosimilar competition
    •Ensure adequate resources for the FDA
    •Invest in biomedical research

    So, where do our patients stand? Its seemingly up to us, as nurses to provide some of this education. Its not enough that providers and physicians prescribe, but we must all be mindful of the cost."



    You meant stimulate generic and biosimilar competition, right?

    You say that nurses need to provide this education - I assume you mean education about the cost of the drugs - but how would I know the cost?

    Wouldn't a social worker be better equipped to help a patient find ways to pay?

    I read part of the article you quoted, but it went over my head.
  4. by   Buckeye.nurse
    People with end stage renal failure automatically qualify for Medicaid because they will die without dialysis. I don't understand why a cancer diagnosis doesn't automatically qualify a patient as well. Doesn't make sense to me
  5. by   DowntheRiver
    This isn't anything new. My chemotherapy (12 rounds of ABVD for Stage II Hodgkin's Lymphoma) was billed to the insurance company at $30,000/treatment for just the medication in 2008. That didn't include any of my scans, doctors appointments, surgeries, and other medications, nor did it include the cost of my wig. I was had just turned 22 and could not afford any of that so my parents paid - $13,000 OOP at the end of the year. I lost my health insurance a year later because the max age used to be 23 for insurance AND during that time I had to remain at least a part-time student to remain on my mom's health insurance. I didn't get health insurance again until I got married at 25 because no one would insure me. Basically, during the most critical time for reoccurrence I did not see a doctor or get follow-up scans. I am very lucky that I am healthy and thriving today.

    I work at a top 10 cancer center as an Oncology nurse and we really do our best to accommodate all patients and giving back to the community.
  6. by   Kooky Korky
    Monsters live among us. They wear suits and meet secretively in boardrooms. They lunch in private clubs or on their private jets or yachts. They carry calculators along with the phone numbers of realtors who work in exotic climes.

    For the treatment of their own or their loved ones' cancer, they go to Germany or other countries where treatment is not limited to certain very costly poisons, as it is in the US.

    It's comparable to Planned Parenthood's (Margaret Sanger's) aim of sterilizing or otherwise limiting the reproductivity of "undesirables".

    Perhaps the day will come, if it hasn't already, when medical tourism will be engaged in for cancer treatment by "commoners".

    Come back quickly, Lord Jesus.
  7. by   KatieMI
    Medical tourism for cancer treatment is flourishing in the USA and well within means for upper middle class' finances. Also, smart people shop for meds all over the world and save big $$$$ this way. Just letting you know. And do not let me start about naturopats of all kinds available immediately right here.

    But the main point is that drugs for cancer are not Epipens. They, especially the newest ones, are ridiculously expensive to develop, make and introduce, and everything about them (delivery systems, monitoring, $$$ to pay that RN who pushes them 36 hours/week, etc) is not coming free from Heaven either. The massive research system, which makes all the above possible, costs even more. And, last but not least, support and treatment of "comorbidities" is possibly the biggest elephant in the room. Obesity alone adds over 20% (that's one fifth part) to the US health care spending.

    Life in Golden Billion has its own negatives. Please consider saving those $2.50 per bag of chips, $6.16 per pack of cigarettes and $5 for empty calories overladen Starbucks drink today, and you might have less problems later.
  8. by   FranEMTnurse
    I have an advance directive that states I do not want to be tube fed, have dialysis should I ever go into chronic kidney failure, nor live on a ventilator should I have a fatal disease. If I'm still well enough, I want to live out the short rest of my life enjoying it by doing the things I love best instead.
  9. by   vintagemother
    Quote from Buckeye.nurse
    People with end stage renal failure automatically qualify for Medicaid because they will die without dialysis. I don't understand why a cancer diagnosis doesn't automatically qualify a patient as well. Doesn't make sense to me
    I have been thinking the same thing. )-:
  10. by   mejsp
    Your comments are thought-provoking. I remember the first time I learned, "What?! you can turn away a cancer patient? Did you see Patch Adams? I admire his healthcare model.

    My husband and I visited with folks from England and Canada who have socialized medicine. They empathize with our mess. I've read about England adopting a nationalized health service after WWII to care for veterans. I dream of a nationalized system for us.

    I once argued with someone who said Americans worship the almighty dollar. I'm not arguing anymore. The lust for power and wealth are intoxicating. And we call ourselves a Christian nation.

    I need to read about Margaret Sanger. I've never heard of her.
  11. by   traumaRUs
    Quote from Kitiger
    Quote from traumaRUs

    "Some of the suggestions from the Panel include:

    •Enable communication about cancer treatment options and include information about cost
    Simulate generic and biosimilar competition
    •Ensure adequate resources for the FDA
    •Invest in biomedical research

    So, where do our patients stand? Its seemingly up to us, as nurses to provide some of this education. Its not enough that providers and physicians prescribe, but we must all be mindful of the cost."



    You meant stimulate generic and biosimilar competition, right?

    You say that nurses need to provide this education - I assume you mean education about the cost of the drugs - but how would I know the cost?

    Wouldn't a social worker be better equipped to help a patient find ways to pay?

    I read part of the article you quoted, but it went over my head.

    Thanks so much for pointing this out and yes, I did mean "stimulate" - this has been corrected.

    The main focus of this article is that drugs for cancer treatment are very expensive. It would be cheaper to have a faster route to develop generics and thus reduce the burden on pts.
  12. by   traumaRUs
    Quote from Buckeye.nurse
    People with end stage renal failure automatically qualify for Medicaid because they will die without dialysis. I don't understand why a cancer diagnosis doesn't automatically qualify a patient as well. Doesn't make sense to me
    ESRD Medicare coverage goes back to the 70's where if you didn't have private insurance, you couldn't pay for dialysis.

    However, there are many forms of cancer, many of which are either completely curable or potentially curable. There are some drug assistance programs but we need to boost the quicker development of cheaper generics.
  13. by   KatieMI
    Quote from mejsp
    Your comments are thought-provoking. I remember the first time I learned, "What?! you can turn away a cancer patient? Did you see Patch Adams? I admire his healthcare model.

    My husband and I visited with folks from England and Canada who have socialized medicine. They empathize with our mess. I've read about England adopting a nationalized health service after WWII to care for veterans. I dream of a nationalized system for us..
    I have to do referrals for one of the most advanced cancer care centers in the country and their paperwork packet has no questions whatsoever about finances except insurance info when it is available. Many of these patients are gestitute. Not all of them are accepted, but most, if not all of those who do not are rejected for medical reasons like documented noncompliance, substance abuse and terminal nature of disease. Programs' coordinators and physicians I speak with always tell to start Medicaid process and let it for SW/CM otherwise.

    I see rejections from there much more rarely than whining about "how can I ever go there - I do not know anybody, I do not have family there, what am I got to do once there??" with the fact that the said center is less than 3 hour drive one way.
    It makes me remembering wonderful times when I had to fly across the country red eyes at least once a month and be there sharp at 7 AM with baby on oxygen and pump so that the doctor who did the procedure on her heart could do ultrasound himself. And, yeah, people get dropped out for banal noncompliance with treatment protocol.

    BTW, I have tons of friends in countries with socialized medicine. So far, two most impressive events were leaving healthy young man on torturous 100% low j- tubefeeding for weeks because his posttraumatic ventral hernia was classified as "plastic intervention" which could wait to be repaired (Australia, wife had education, knew about forming adhesions and increased risks of delayed surgery, they had to fly to Germany to get it done within reasonable timeframe; paid out of pocket and he was back to work before hus surgery could ever be scheduled at home) and a young woman who was told that her breast mass should be watched for 6 months before doing anything (in 6 month it was already stage II of highly aggressive cancer; the following was 6 years long ordeal which had to be done partially in Germany because England had no center using the particular protocol for her case. The patient had private insurance in addition to government and had access to every academic center in Great Britain. In the same situation last year, I had biopsy arranged within one week in middle-of-nowhere USA and knew I had nothing to worry about in less than a month from the point of discovering a mass).
    Last edit by KatieMI on Mar 18
  14. by   SpankedInPittsburgh
    I'd probably buy groceries as starvation will usually kill you quicker than cancer. However, this is an incredibly poor choice that Americans shouldn't have to make. If we can fund a multi-decade ill-fated, going to nowhere misadventure in the middle east costing untold billions we should be able to help our fellow citizens avoid such a choice even if it means giving up our role as world policemen.

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