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General Surgery

High-Cost Drugs

Breast cancer research and treatment has advanced in leaps and bounds in the past 20 years. However, the costs of treatment and follow-up care have become a financial burden on patients and their families.

It seems like every advance in technology brings with it a step up in the costs as well. With the new hope that novel medications bring, patients also have to face its related costs. The rising costs seem to be the price to pay for positive care outcomes: Treatments are associated with fewer side effects, higher quality of life, and have caused a drop in the number of deaths in the US.

In 2010, the cost of breast cancer care was $16.5 billion, accounting for approximately 13% of total costs for all cancer care in the US. Patients have to shell out tens of thousands of dollars every year.

As many cannot afford such expensive treatment, low-income patients usually discontinue treatments or opt out of therapies. This has a direct effect on the treatment outcome and an oncologist’s practice, because of which many are not very open about the costs and the complete treatment that would be needed. Others feel that they don’t have sufficient knowledge to interpret economics while making clinical decisions. This discomfort from both ends is a big obstacle, as they wonder how this information will affect the other’s decisions. This underscores the need to educate caregivers on treatment costs and circumstances of the patient.

With the high ambiguity in the diagnosis, insurance companies are feeling the financial strain as well, as they pay for tests and treatments that have not shown any benefits.

In their defense, the pharma industry argues that high-priced drugs (in view of their efficacy) save on other tests, treatments and even extended hospitalization, affording long-term benefits in quality of life.

Patients can try to balance these costs with benefits by being aware of what exactly is covered in their health insurance plans. The rising healthcare costs is not individualized to only the patient but is a national concern that has spurred American Recovery and Reinvestment Act of 2009 and The National Cancer Act of 1971. The government offers the Consolidated Omnibus Budget and Reconciliation Act of 1986 (COBRA), which allows patients to continue coverage after leaving their employment during treatment. The patient can also gain coverage from a new employer on shifting jobs as mandated by U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA).