Vinay Prasad, MD, MPH, assistant professor of medicine at the Oregon Health & Science University Knight Cancer Institute in Portland, said this is becoming a greater concern than ever before.
“We are already thinking about biological toxicity, and now we have to think about a whole new class of toxicity. We have to deal with these toxicities and no longer ignore them,” Dr Prasad told Cancer Therapy Advisor.
The study suggested that the effects of ﬁnancial insolvency on the mortality of patients with cancer may be similar to or even exceed observed socioeconomic disparities in survival outcomes.1 Subsequently, if interventions can be put in place to reduce severe ﬁnancial distress after a cancer diagnosis, it may be possible to improve outcomes.
One way to combat the rising costs of many new cancer therapies is to create new policies that expand access to patient assistance programs. Some clinicians also say it may be time to put limits on out-of-pocket expenses for patients with cancer.
Bryan McIver, MD, PhD, deputy physician in chief of the Moffitt Medical Group and leader for the Endocrine Tumor Program at Moffitt Cancer Center in Tampa, FL, explained that therapies for lung and thyroid cancers in particular are significant causes of bankruptcy. Although thyroid cancer has a good prognosis, expensive treatments bankrupt patients.
“If you are bankrupt, you are not likely to go in for care right away when a problem arises,” Dr McIver said in an interview with Cancer Therapy Advisor. “The tests are expensive, and patients who are living on the edge end up rationing their care. We need to educate community providers to learn their patients’ limits and develop optimal standards of care.”
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He said clinicians often don’t do a great job of estimating or judging the cost-benefit ratio of many new cancer therapies and that this current study highlighted how much that may cost in terms of clinical outcomes.
Dr Prasad agreed. “Some new therapies cost more than $100 000 a year. Some are worth every penny, but some are very marginal in terms of benefit.”
- Ramsey SD, Bansal A, Fedorenko CR, et al. Financial insolvency as a risk factor for early mortality among patients with cancer [published online ahead of print January 25, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.64.6620.
- Ramsey S, Blough D, Kirchhoff A, et al. Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis. Health Aff (Millwood). 2013;32(6):1143-1152.