High Cancer Drug Costs Could Result in Drug Non-Adherence

Findings from a new study suggest that cancer survivors may change their prescription drug regimens due to increased out-of-pocket costs.

The high cost of cancer treatment can cause a significant burden for patients, their families, and the healthcare industry. New treatments can cost patients more than $100,000 per year, and may present a barrier to receiving cancer care.

Due to high-deductible plans, increasing co-payments, co-insurance, and drug tiering, a large portion of cancer drug costs have been shifted to patients, according to the study, published by CANCER.

Additionally, since a growing proportion of newer cancer drugs can be administered orally by the patient, they may delay, skip, or forgo treatment in order to control costs.

Included in the study were responses from 9000 patients with a history of cancer and 93,000 patients without cancer.

The researchers discovered that 31.6% of newly diagnosed patients and 27.9% of cancer survivors changed prescription drug regimens for financial reasons, while only 21.4% of control patients reported this behavior, according to the study.

Approximately 31.3% of non-elderly cancer survivors who were enrolled in high-deductible plans requested their physicians prescribe them less-costly treatments, compared with only 22.5% of control patients making this request.

"Specifically, non-elderly cancer survivors were more likely to skip medication, delay filling a prescription, ask their doctor for lower-cost medication, and use alternative therapies for financial reasons compared with non-elderly individuals without a cancer history," said senior study author Ahmedin Jemal, DVM, PhD.

The investigators also found that as comorbidities increased, patients were more likely to change prescription drug use, according to the study. However, in the long-term, out-of-pocket costs may increase due to disease progression and related adverse events.

These changes were especially evident among non-elderly patients. The study authors hypothesize that since nearly all elderly patients are enrolled in Medicare, their costs for cancer treatment are better controlled.

Since treatment responsibility has largely been transferred to patients, it is important that physicians take an active approach to remind patients of the importance of adherence to cancer drugs.

It is also important that physicians and patients weigh the benefits of cancer treatment against the costs to determine its worth. This approach may prevent patients from skipping treatments later on.

"Healthcare reforms addressing the financial burden of cancer among survivors, including the escalating cost of prescription drugs, should consider multiple comorbid conditions and high-deductible health plans, and the working poor," Dr Jemal said. "Our findings also have implications for doctor and patient communication about the financial burden of cancer when making treatment decisions, especially on the use of certain drugs that cost hundreds of thousands of dollars but with very small benefit compared with alternative and more affordable drugs."