Many Cancer Patients Face Crippling Costs

These studies drill down from the macroeconomic to the individual cancer patients feeling the burdens of increased insurance costs and more cost sharing for their treatment. Cancer diagnosis is associated with the greatest individual burden for health care costs, with more than 13% of patients spending more than 20% of their income. Additionally, the Kaiser Family Foundation reports 20% of cancer patients use all of their savings on their cancer care.

Over 50 million Americans are uninsured, and ample data show that lack of insurance is associated with late diagnosis of cancer. Additionally, every 1% increase in unemployment results in another 1 million citizens losing health insurance. As the numbers of uninsured and underinsured increase, the divide grows between the haves and the have-nots in our society. The disparities will result in more delays in seeking care, decreased access to treatment, and more financial burdens including more personal bankruptcies.

Trends in health care spending threaten our nation’s health. In 2010, the NIH estimates that we spent $264 billion on cancer, $103 billion of that on direct medical costs. We need more patient-physician discussions about the costs of care, as well as educational and support tools to promote effective communication about costs and to guide patients’ evaluations of treatments and their impact on outcomes. We need a better understanding of the factors that drive the costs of cancer care and how the cancer care system can be modified to ensure that all Americans have access to high-quality, cost-effective care.

Dr. Neal J. Meropol was the discussant of the papers at the ASCO meeting. Dr. Meropol is chief of hematology-oncology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland. He is an advisor or consultant to AstraZeneca, Genentech, Genomic Health, and Helsinn.