Advocates Call for Action to Address Rising Cost of Treating Cancer

The escalating cost of treating cancer has sparked concerns across the health care spectrum, from prescribers to patients.

To address this growing challenge, the Leukemia & Lymphoma Society (LLS) released a progress report on dozens of recommendations and potential policy solutions the organization proposed more than a year ago. Despite some advances toward the goal of easing the cost burden on patients, there is still a significant gap to overcome.

“While some headway has been made this year to address increasing out-of-pocket costs faced by cancer patients for their treatments and care, far more action is needed to address the financial toxicity that adds to the stress of a cancer diagnosis for patients and their families,” Louis J. DeGennaro, PhD, LLS president and CEO, said in a press release. “As the world’s leading nonprofit dedicated to fighting blood cancers, LLS is uniquely positioned to facilitate this collaboration among players in the health care ecosystem and to advocate for patients.

“We’ve invested more than $1.2 billion in cutting-edge cancer research, resulting in lifesaving treatments and cures for some patients. But new treatments can’t help patients who don’t have access to them. We must do more to help break down the cost barriers to treatment.”

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The LLS pointed to several sobering facts regarding cancer care in the United States that emphasizes the current challenges facing the health care system, including more than 600,000 annual deaths from cancer and more than 1.3 million Americans currently living with or in remission from a blood cancer. By 2020, the annual cost of cancer care in the United States is predicted to reach $173 billion, a 39% increase since 2010, according to the LLS.

In May 2017, the LLS presented a series of recommendations to lower out-of-pocket spending for patients with cancer, such as promoting frank discussions among providers and patients regarding the costs and benefits of each treatment option, a push towards more innovative value-based reimbursement models, and promoting competition in the pharmaceutical marketplace to lower drug pricing.

Among the proposed policy changes that have been adopted or are under consideration, the FDA has started expediting the review process for generic drugs and the passage of legislation that lowers out-of-pocket spending among patients on Medicare Part D who opt for biosimilars.

The LLS said it has also played a significant role in pushing forward oral parity laws, which guarantee equitable coverage for oral treatments infused at a specialty pharmacy instead of a hospital or clinic. At the beginning of 2018, Arkansas became the 43rd state to require payers to provide oral parity protection for patients with cancer, according to the LLS.

“LLS is pushing for more relief for patients. For example, LLS is advocating for policymakers to eliminate some of the perverse payment incentives that lead hospitals to acquire private physician practices, a decision that typically hikes patient co-pays,” Gwen Nichols, MD, LLS chief medical officer, said in a press release. “When cancer patients are fighting for their lives, the last thing they need is financial distress.

“LLS receives thousands of calls each year from cancer patients and their families about financial stress and difficulties accessing treatment. It is clear that we still have a very long way to go to find solutions.”