Treating Cancer: Why So Costly?

When you’re battling a life-threatening disease, the last thing you want to do is worry about the cost of the treatments that could save you. Yet a new study points out that is precisely a question breast cancer patients (specifically) may want to ask — if for no other reason than to prepare for the bill.

Researchers at the University of Texas MD Anderson Cancer Center in Houston recently found the costs of breast cancer chemotherapies vary widely, even among treatment regimens with similar efficacy. Across one class of drugs, costs even varied as much as $46,000. The study also showed how substantial the out-of-pocket costs are for some patients.

The costs of breast cancer chemotherapy vary widely, even among treatment regimens with similar efficacy.

The review is the first to look at these cost differences, and to provide clinicians with accessible information to answer patient questions about treatment options. The results are published online in CANCER, a peer-reviewed journal of the American Cancer Society.

“The highest priority is always to provide patients with the most effective treatments, and those with the least side effects,” said Sharon Giordano, M.D., of the University of Texas MD Anderson Cancer Center in Houston and the lead author of the study. “Sometimes, lower cost alternatives are not the best options, and I would never encourage a patient to choose a less effective treatment because of cost concerns,” Giordano told LifeZette. “However, cost information can still be useful to patients to consider as they make other life decisions and for management of their overall household budgets.”

To estimate the costs to payers and patients for breast cancer treatment regimens, the team looked at information on 14,643 women who were diagnosed with breast cancer between 2008 and 2012 and who received chemotherapy within three months of diagnosis. Total costs and out-of-pocket costs were calculated using all claims within 18 months of diagnosis.

Less costly treatment regimens versus the most expensive regimen could reduce national costs of breast cancer care by more than $1 billion a year.

Among patients who did and did not receive trastuzumab — which targets the HER2 protein that is over-expressed in certain types of breast cancer cells — the median insurance payments were $160,590 and $82,260, respectively.

For patients who did not receive trastuzumab, the median out-of-pocket payment was $2724, and 10 percent of patients paid more than $7,041. For patients treated with trastuzumab, the median out-of-pocket payment was $3,381 and 10 percent paid more than $8,384.

Among patients on high deductible health plans, the median out-of-pocket cost was $5,158 and 10 percent of patients paid $11,344 or more.

“We found a wide variation in costs between these regimens, which could result in unnecessary costs to both patients and the health care system,” said Giordano. She said many patients had high out-of-pocket costs for their care. The authors noted that the use of an equally effective but less costly treatment regimen versus the most expensive regimen could reduce national costs of breast cancer care by more than $1 billion each year.

Related: Good News (Maybe) in the War on Breast Cancer

As cancer care costs continue to rise, putting a heavy burden on patients and their families, Giordano said it’s important that patients discuss any concerns with their physicians. It may not be easy to comparison shop on prices, but it is possible.

“Doctors might not always know how much treatments will cost, but they can help their patients find the information. In some clinical situations, the doctors may have lower cost but equally effective alternatives,” said Giordano.

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She added that patients should check with their insurance companies to find out how much they will be responsible for in out-of-pocket costs. Sometimes, the doctors’ offices may be able to help provide the information, but the situation can be different across different health plans.