"The initiative is the latest response to rising concerns over “financial toxicity,” the economic devastation that can be wrought by the high cost of cancer care. With new oncology therapies routinely debuting at more than $100,000 a year, “lots of people are worried about developing drugs that people can't get,” said Leonard Saltz of Memorial Sloan Kettering Cancer Center in New York, who helped organize the new group."
"According to the results of the Short-HER study, “There may be a protective effect from a shorter duration of trastuzumab therapy” against cardiac toxicity, discussant Carey K. Anders, MD, of The University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center, said.
There was no difference in OS at 5 years, and the smaller subset analysis found that patients with stage III disease with multiple positive lymph nodes “appeared to derive greater benefit from the longer duration of trastuzumab.”
After surgery for lymph node–positive colon cancer (stage III), some patients may need only half of the long-standing standard course of chemotherapy. In an analysis of 6 clinical trials with over 12,800 patients, 3 months of chemotherapy was nearly as effective as 6 months in patients with relatively lower recurrence risk and caused fewer side effects, particularly nerve damage.
Patients taking abiraterone acetate typically stay on the medication for 12 to 18 months. Since 2011, according to the manufacturer’s website, more than 100,000 patients in the United States alone have filled prescriptions for abiraterone.
If each of those 100,000 patients had taken the drug for 12 months and, theoretically, paid the list price out of pocket but took the lower dose with food, the 75-percent cost reduction could have saved them more than $6 billion.
"The primary take-home message is that even in a population in which everyone has some health insurance, many people end up paying a significant share of their incomes in out-of-pocket expenses, and it might not be something they were planning for,” said study co-author Lauren Hersch Nicholas, a health economist at the Johns Hopkins Bloomberg School of Public Health."
"Historically physicians have focused on survival—prolonging a patient’s life. Over the past 20 years, we began thinking about how the physical side effects of cancer treatment—vomiting, headaches or hair loss—affect a patient’s quality of life. Financial toxicity is another important side effect that needs to, at the very least, be disclosed to patients, though it’s often taboo for physicians to think about cost, let alone discuss it in the context of care."
"This study found strong evidence of a link between cancer diagnosis and increased risk of bankruptcy," wrote the authors, led by Dr. Scott Ramsey, an internist and health economist at the Center. "Our study thus raises important questions about the factors underlying the relationship between cancer and financial hardship."