Study: Cancer treatment costs can vary widely
Contents
At a glance | In-depth |
Findings | Limitations |
Clinical trials | Resources |
Questions for your doctor |
STUDY AT A GLANCE
This study is about:
The costs associated with different breast cancer treatments.
Why is this study important?
Cost is an unfortunate but important factor for patients when deciding on a treatment regime. Even patients who have insurance may have high out-of-pocket costs. Healthcare providers want to give their patients the best treatments possible and patients want these treatments, but what if that is something patients can’t afford? Previous research established a link between high costs of cancer care and lower adherence to medications, and increased risk of bankruptcy as well as psychological and material difficulties. Additionally, while healthcare providers know that communicating treatment costs is important for patients, it does not often occur because cost information is simply not available.
Study findings:
- The median insurance payment for patients who have private insurance and received one of the trastuzumab (Herceptin)-based treatments (the for HER2+ breast cancer) was $160,590. The median out-of-pocket payment was $3,381. This means that about half of the patients paid more than $3,381 and about half paid less.
- 25% of patients paid more than $5,604 out-of-pocket and 10% paid more than $8,384 out-of-pocket.
- The median insurance payments for patients who have private insurance and received one of the non-trastuzumab treatment (for patients with HER2- breast cancer) was $82,260. The median out-of-pocket payment was $2,724. This means that half of patients paid more than $2,724 and half paid less.
- 25% of patients paid more than $4,712 out-of-pocket and 10% paid more than $7,041 out-of-pocket.
What does this mean for me?
This study suggests that breast cancer treatment costs can be very different depending on the type of treatment and the patient’s insurance coverage. The authors of this study wrote, “Because of the rising costs of care and increased for patients, the expense of treatment is becoming more relevant to patients and their families, and providers need more accessible information to be able to answer patients’ questions about the financial impact of their treatment choices.” More work needs to be done so healthcare providers can have this information for their patients.
Posted 11/22/16
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References
Giordano SH, Niu, J, Chavez-MacGregor M, et al. “Estimating Regimen-Specific Costs of Chemotherapy for Breast Cancer: Observational Cohort Study.” Cancer. Published online first on October 10, 2016.
Disclosure
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
People diagnosed with breast cancer
This article is also relevant for:
people with breast cancer
people with ER/PR + cancer
people with Her2-positive cancer
men with breast cancer
people with metastatic or advanced cancer
people with triple negative breast cancer
people newly diagnosed with cancer
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IN DEPTH REVIEW OF RESEARCH
Study background:
Cost of treatment is an important subject that many patients want their healthcare providers to address. This is especially important for patients who have the choice between similar treatment options. HER2+ and HER2- breast cancer patients have quite a few options to choose from—the National Comprehensive Cancer Network guidelines identify 12 acceptable chemotherapy regimens for HER2- breast cancer patients and 9 acceptable chemotherapy regimens for HER2+ breast cancer patients. Unfortunately, not a lot of cost information is available for healthcare providers to share with their patients to help them with these decisions.
Sharon Giordano and colleagues from The University of Texas MD Anderson Cancer Center published work in 2016 in the journal Cancer to get a better idea of breast cancer treatment costs for breast cancer patients.
Researchers of this study wanted to know:
What are the costs for U.S. breast cancer treatment from both the insurance companies’ and patients’ perspective?
Population(s) looked at in the study:
The 14,643 women in this study were 18-years-old or older and had breast cancer diagnosed between 2008 and 2012. About 24% received therapy that included the trastuzumab (Herceptin), a for HER2+ cancer, while 77% received non-trastuzumab regimens including taxanes such as docetaxel, platinum-based drugs such as carboplatin, and anthracyclines. Women in the study also had surgery, and, where appropriate, hormone therapy. All women in the study had private insurance and received treatment within 3 months of diagnosis. Costs were evaluated for up to 18 months after diagnosis.
Study findings:
- The median insurance payments for patients who have private insurance and received one of the trastuzumab-based treatment (the chemotherapy for HER2+ breast cancer) was $160,590. The median out-of-pocket payment was $3,381.
- 25% of patients paid more than $5,604 out-of-pocket and 10% paid more than $8,384 out-of-pocket. This means that about half of the patients paid more than $3,381 and about half paid less.
- The median insurance payments for patients who have private insurance and received one of the nontrastuzumab treatment (for patients with HER2- breast cancer) was $82,260. The median out-of-pocket payment was $2,724. This means that about half of the patients paid more than $2,724 and about half paid less.
- 25% of patients paid more than $4,712 out-of-pocket and 10% paid more than $7,041 out-of-pocket.
- Costs varied within similar therapy regimens. For example, for patients who received a trastuzumab-based treatment, the median insurance payment costs differed by about $20,000.
Limitations:
This study does not include information on patients without insurance—these patients face considerably higher out-of-pocket costs.
Because this study used an 18-month time frame, the researchers could not estimate total costs of breast cancer care. For example, patients who underwent breast reconstruction beyond the 18-month window or may have received hormone therapy for 5-10 years. And because the source data used for this study were not linked to any cancer registry data, researchers were unable to look at the patients’ cancer , race/ethnicity or tumor characteristics.
Finally, the researchers were unable to look at newer drugs that have been released since the data was collected.
Conclusions:
This study suggests that breast cancer chemotherapy costs vary widely. More work needs to be done so healthcare providers can provide patients with accurate cost information. Until this happens, patients should have frank discussions with their healthcare providers about cost and how it will affect them.
Posted 11/22/16
Share your thoughts on this XRAYS article by taking our brief survey
- How much will my treatment cost?
- Will insurance providers cover this treatment cost?
- What are the projected copays or deductibles associated with my cancer treatment with my insurance coverage?
- Are there any options or financial arrangements that will allow me to pay my treatment costs over time?
- Are there open clinical trials that are appropriate for me?
- If alternative treatments are available, what are the benefits, risks and costs of each?
- NCT03572374: Talking to Employers and Medical Staff About Breast Cancer Treatment and Your Job (TEAMWORK Study). This study will learn more about how breast cancer treatment affects patients' employment. Researchers are testing an early version of the TEAMWork (Talking to Employers And Medical staff about Work) mobile app, which is designed to help breast cancer patients keep their jobs during and after treatment.
- NCT02333604: Cancer Experience Registry. This web-based registry distributes surveys to better understand the social, emotional, physical, financial and decision-making experiences of cancer patients and their caregivers.
- NCT04960787: Financial Navigation Program to Improve Understanding and Management of Financial Aspects of Cancer Care for Patients and Their Spouses. This clinical trial examines a financial navigation program that helps patients and their spouses understand and better manage the financial aspects of cancer care.
- NCT04931251: Addressing Cancer-Related Financial in Rural Oncology Care Settings. The study conducts a financial navigation program in 5 rural and 4 non-rural oncology practices in North Carolina. This study also evaluate the effects of financial navigation on patient outcomes, including financial and health-related quality of life.
- NCT04766190: DISCO: A Patient Intervention to Reduce the Financial Burden of Cancer. The DISCO App is designed to improve patient-and-doctor communication about costs of care.
Updated: 04/04/2023
Who covered this study?
Reuters
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