The Clinton Herald, Clinton, Iowa

Food & Health

May 7, 2014

Chemo costs driven higher by outpatient shift

WASHINGTON, D.C. — The price of cancer drugs has doubled in the past decade, with the average brand-name cancer drug in the U.S. costing $10,000 for a month’s supply, up from $5,000 in 2003, according to a new report by IMS Institute for Healthcare Informatics, a health information, services and technology company.

And those are just average prices; some drugs may cost as much as $30,000 a month.

In Europe, where governments negotiate for national discounts, the list prices of cancer drugs are at least 20 to 40 percent lower than in the United States, the report found.

Americans are also paying higher prices because more patients are being treated by oncologists whose practices have been bought by hospitals, which may charge double or more for the same treatments, the report said.

The report’s authors calculated prices for 10 common chemotherapy treatments and found hospitals charged 189 percent more on average — or nearly triple — what the same infusions would cost in an independent doctor’s office. The higher charges, which hospitals say are needed to support overhead and administrative costs, often translate into steeper out-of-pocket costs for insured patients, depending on how their benefits are set up.

The report calculated that for commonly used cancer drugs, the average increased cost to the patient is $134 per dose if received in a hospital outpatient setting rather than in an oncologist’s office. And since patients frequently receive multiple therapies at once, the results may result in “significant increases in member financial burden,” it said.

Patients who face higher out-of-pocket costs are more likely to drop out of treatment, the report noted, citing a study showing that a bump of as little as $30 in copays caused some breast cancer patients to skip or drop care.

Steve Weiss of the American Cancer Society’s Cancer Action Network said advocates are concerned that the trends identified in the report could limit access to life-saving care by driving up patients’ costs. While the Affordable Care Act takes important steps to make care more accessible to patients, “health care costs remain a concern as they have been for decades,” he said. “As we’ve seen repeatedly over the year, there are no easy answers.”

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