Cancer drug costs are skyrocketing, leaving even insured patients in financial ruin

Written by George Citroner via The Epoch Times (emphasis ours),

The rise in cancer cases is putting pressure on Americans who already face a difficult situation: exorbitant drug prices, a lack of regulation and a system that seems designed for profit, experts say.

With medical debt burying patients, the battle against cancer is taking on a new financial front that could bankrupt many cancer patients.

Emerging patterns in cancer data

For more than seven decades, cancer has remained among the two leading causes of death. More than one-third of the US population will face a cancer diagnosis in their lifetime, according to estimates from the National Cancer Institute.

A new study published in Open JAMA Network Analysis of cancer data from 3.8 million patients reveals a trend: Generation X, those born between 1965 and 1980, is experiencing a sharper increase in cancer rates across the major types than any previous generation that dates back to 1908. This trajectory suggests that the high incidence of cancer in the United States may persist for decades to come, representing a looming public health crisis.

The death rate from cancer in the United States has fallen steadily year after year since 2000, but the rate of newly diagnosed cases is increasing. By 2024, more than 2 million new cases of cancer are expected in the United States, according to data published in A cancer journal for physicians. This is from 1,958,310 new cases in 2023.

The incidence rate of six of the 10 leading cancers is also increasing. Incidence increased annually by 0.6 to 3% between 2015 and 2019 for HPV-related cancers such as breast, pancreatic, prostate, liver, kidney, and oral cancers.

“Epidemic of early-onset cancer”

research published in 2022 points to an “epidemic of early-onset cancer.” Some evidence suggests a 79.1 percent global increase in early-onset cancers between 1990 and 2019 and a nearly 30 percent increase in related deaths.

Although the causes are unclear, scientists suggest Accelerated aging due to factors such as diet, lifestyle and environmental exposure can play a role.

A Report 2024 shows younger adults as the only age group with increased global cancer incidence from 1995 to 2020, increasing by 1 to 2 percent annually. Rates of breast, prostate, endometrial, colorectal, and cervical cancer are also increasing in this population.

Young adults experienced a 1% to 2% annual increase in cervical cancer (ages 30-44) and colorectal cancer (under 55) between 2015 and 2019. Colorectal cancer passed from the fourth leading cause of cancer death in the late 1990s to the first in men and second in women under 50.

The growing financial toll

As more cancer diagnoses hit younger and working-age Americans, those affected are facing financial hardship due to the skyrocketing costs of potentially life-saving treatments.

According to recent survey of the American Cancer Society's Cancer Action Network.

Forty-seven percent of the more than 1,200 cancer patients and survivors surveyed have accumulated debt due to their cancer treatment, with 49 percent carrying a burden of more than $5,000. As many as 69 percent have been struggling with this debt for more than a year, and more than a third (35 percent) have been saddled with cancer-related debt for three years or more.

Almost all (98%) of these respondents were insured when the debt was incurred, and high-deductible health plans without a health savings account were the most common coverage (34%).

The findings suggest that people with cancer-related medical debt are three times more likely to fall behind on recommended cancer screenings (18 percent vs. 5 percent). Twenty-seven percent have gone without adequate food, while another 25 percent have been forced to skip or delay essential care because of crippling debt.

According to recent report prepared for the American Hospital Association by Healthsperien, a public health consultancy. While inflation was roughly 6.4% from January 2022 to 2023, the average price of cancer drugs rose 15.2% in 2023 and 32% a year earlier.

The average price for oncology drug treatment is $257,000 per year on average, 3.7 times that of non-oncology drugs. Compounding the problem, the average inflation-adjusted launch price of oral cancer drugs rose more than 25 percent between 2017 and 2022.

If these trends persist, the average self-administered cancer drug could cost more than $300,000 a year by 2025, exacerbating the financial burden on patients and limiting healthcare resources, the report said.

The role of the healthcare system in the price of medicines

The overall healthcare system is to blame for exorbitant drug prices, Pavani Rangachari, a professor of healthcare administration and public health at the University of New Haven, told The Epoch Times.

The lack of price regulation and bargaining in the US system allows drug companies to enjoy “free rein” in setting prices, even for drugs with minimal life-extending benefits, such as they extend survival by only three to four months, he added. Patients could rack up more than $150,000 in costs for certain cancer drugs in that short period of time, Ms. Rangachari.

Although the high costs associated with “bench-to-bedside” drug development contribute to the problem, pharmaceutical companies essentially have monopolies due to patent protection, allowing them to maximize profits.added.

Companies can also partner with providers and doctors and incentivize them to keep prescribing expensive drugs, Ms. Rangachari.

Adding to the problem is the nature of cancer treatment itself, where patients often require multiple sequential drugs, and the burden of medical debt persists even as they transition to new drugs.

A medical system that needs reform

The problem of expensive cancer drugs is a systemic problem that demands government intervention through value-based purchasing models, said Ms. Rangachari.

These alternative payment systems allow states to negotiate lower drug costs with manufacturers, who should also be required to demonstrate the cost-effectiveness of their cancer treatments, as is the practice in other developed nations through pricing based on value linked to health outcomes and quality. adjusted life years.

However, the burden does not fall solely on pharmaceutical companies. All stakeholders, including cancer centers, need to increase transparency for cancer patients, as the financial hardship for them extends beyond medical costs to indirect factors such as lost productivity.

Despite the flaws in the current system, some cancer centers have begun to detect financial problems among patients and offer services to help them. “That can make a big difference,” said Ms. Rangachari. Insurers can ease the strain on patients by reducing prior authorization requirements, accounting for off-label drug use, minimizing coverage restrictions and lowering out-of-pocket maximums, he added.

Ms. Rangachari emphasized the unsustainability of the current system as insurers stand to be the biggest losers due to premium pricing issues arising from high variability in drug costs. He questioned how insurers could set premiums amid unpredictable drug prices, highlighting the risk that high costs would unfairly burden patients.

There will likely be pushback from powerful entities as the Centers for Medicare and Medicaid Services (CMS) implements value-based pricing, Ms. Rangachari. “So the government has to prepare for a big fight.”