Financial toxicity of cancer treatment — time to intervene?
Those diagnosed with cancer face more than just a brutal disease. Too often, patients and their families are faced with a heartbreaking decision.
Bankruptcy or death.
The fact is, once you are diagnosed with cancer, you are also diagnosed with one of the most prevalent and expensive diseases in the world.
It’s no wonder that cancer patients are 2.6 times more likely to declare bankruptcy and that one in three working-age cancer survivors are in debt, according to studies by the Fred Hutchinson Cancer Research Center in Seattle and Kaiser Permanente Research.
This phenomenon is called financial toxicity, caused in part by a seemingly uncontrollable rise in drug costs and treatments. This trend has continued for decades and has just begun to boil over to receive widespread attention.
You’ve likely heard the story of pharmaceutical CEO Martin Shkreli. His story went viral after his start-up company jacked up the price of a 62-year-old drug overnight from $13.50 per tablet to $750. The news in 2015 shocked many but the sad fact is that that type of price gouging happens all the time.
Take for instance, a Christmas Day report in the Wall Street Journal that found a 40-year-old cancer drug’s price had risen 1,400 percent over the past 5 years or a recent report in the Journal of Clinical Oncology that found that the prices of injectable cancer drugs are rising faster than inflation.
A Mayo Clinic study puts the historical rise in cancer drug prices into perspective.
Think back to 2000. Not that long ago, right? Back then, the average cost of one year’s worth of cancer drugs was between $5,000 to $10,000.
A dozen years later in 2012, that average skyrocketed to $100,000, according to the study.
The financial burden of cancer is often worsened because many cancer patients are unable to work for extended periods of time. Some are even forced to leave their jobs temporarily or permanently. Losing income is hard enough. Losing the insurance that came with the job can be crippling.
Financial toxicities have major impacts on outcomes as well. For instance, a pilot study conducted by researchers at Duke University North Carolina, showed that 42 percent of insured cancer patients reported a significant or catastrophic subjective financial burden and a fifth even reported taking less than the prescribed amount of medications as a result.
As a cancer doctor, it breaks my heart to see patients unable to afford a treatment that could cure their cancer. As a society, we have to do something. How can we get healthier?
This uncontrollable rise in healthcare costs must end.
I was born and raised in Nepal, a low-income country severely lacking in healthcare infrastructure. In the U.S., a rich country idolized by many in the developing world, these problems can and should be solved.
The good news is that organizations across the U.S. have begun to recognize financial toxicities as a major health problem. Studies are being conducted to track down causes and possible solutions.
But real change, as with any movement, requires awareness and knowledge of the general public. Together, as citizens of a prosperous nation, we must first recognize financial toxicities as a public health epidemic before we can truly begin to tackle the issue.
Dr. Binay Shah is an oncologist and hematologist at PeaceHealth. He is the Founder and President of the Binaytara Foundation, an international cancer health nonprofit based in Bellingham.
