Evidence-Based Oncology Looks at How the Cost of Cancer Care Affects Treatment

FOR IMMEDIATE RELEASEAugust 31, 2016

PLAINSBORO, N.J.—It’s the paradox that confronts providers and patients at every level of cancer care: there are more life-saving treatments than ever, yet cost puts so many of them out of reach.

So common, and so troubling is this problem that researchers now refer to “financial toxicity” as the effect that cost burdens have on cancer patients and families alike. Questions, and possible solutions, to this problem are examined in the current issue of Evidence-Based Oncology (EBO), a publication of The American Journal of Managed Care.

As EBO Editor-in-Chief Joseph Alvarnas, MD, writes, “The issue of cost sharing in oncology care sits squarely at the intersection of our aspirations to deliver precision-medicine solutions while attempting to foster an economically sustainable cancer care system.”

The issue features data prepared by the Patient Access Network Foundation (PAN), which helps insured patients who still have high out-of-pocket costs for cancer or other diseases meet their co-payment obligations. Helaine E. Resnick PhD, MPH, and her co-authors found that the amount of support patients with cancer needed for out-of-pocket expenses—the “financial gap—widened considerably between 2011 and 2015, both in real terms and relative to other conditions. By 2015, cancer patients accounted for 52.2% of the PAN Foundation’s spending, but only 40.5% of its beneficiaries.

Young adult cancer survivors are especially hard hit by the cost of cancer treatment, according to authors from The Samfund. Samantha Watson, MBA, and Michelle Landwehr, MPH, leaders of the organization that assists young adult survivors, report that the average net worth of the group’s grant receipts is negative $35,000, while the average net worth of young adults in the general population is $68,000.

Jeffrey W. Chell, MD, writes of the need to remove barriers to bone marrow and cord blood transplants, which sometimes offer the only hope of a cure for patients with a blood cancer such as leukemia or lymphoma. In the past, finding a donor match was the biggest challenge, but the advent of precision medicine and DNA testing has changed that. Today, the biggest problem is gaining payer coverage, especially in Medicare, where coverage is both inconsistent and inadequate.

Other topics covered in the issue include solutions for reducing patient cost sharing, and a discussion of whether the cost sharing burden affects cancer outcomes, by EBO Managing Editor Surabhi Dangi-Garimella, PhD.

About the Journals and AJMC.com

The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.