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Multiple Myeloma Diagnosis- Costs, Financial Toxicity, Rationing

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The cost of multiple myeloma is almost as debilitating as the cancer itself. Do everything you can to learn about and prepare yourself for the financial toxicity caused by a multiple myeloma diagnosis.

What is financial toxicity???

When I received my multiple myeloma diagnosis in early 1994 I knew nothing about either my cancer or the cost of cancer care much less the financial toxicity caused by a MM diagnosis. I was 34 and focused on my career, my family and my friends. If you or someone you love has been diagnosed with cancer then you are probably in a similar situation.

Managing the financial aspects of a MM diagnosis are difficult.

But it can be done. Many health insurance companies have patient advocates. People who can help you figure out what your plan covers and what it doesn’t. Or what is in network what isn’t.

I am both a MM survivor and MM cancer coach. Have you been diagnosed with MM? Do you have any questions about the financial toxicity of a multiple myeloma diagnosis? Please scroll down the page, post a question or comment and I will reply ASAP.

To Learn More About Diagnostic Criteria for Multiple Myeloma Click Now

thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Out-Of-Pocket Costs Play Major Role in Treatment Adherence for Cancer Patients

“The cost of insurance co-payments for cutting-edge pharmaceuticals can vary widely from patient to patient. When the patient’s share of prescription costs becomes too high, many patients skip doses or stop taking medication entirely…”

The Cost of Cancer Treatment

Cancer is a costly illness. It can take a toll on your health, your emotions, your time, your relationships – and your wallet. There will be unforeseen and unexpected charges and even the best health insurance won’t cover all your costs.

Costs you have to pay because your health insurance doesn’t are called out-of-pocket costs. They can add up quickly and affect your ability to pay for other things you need. In some cases, the cost is so high a person decides to stop cancer treatment early, or not get it at all. Sometimes this ends up costing more later on. But the bigger problem is that skipping treatment can worsen health outcomes.

Sometimes there are things a person can do to try to lower the cost of cancer and its treatment and still get excellent cancer care.

You might feel as if you don’t have the energy to deal with cancer and talk about money, too. Think about getting a friend or family member to keep tabs on costs for you. This person can go with you to the doctor to help with this discussion.

Here are some tips on what costs you can expect. We also share some ideas on how to plan for, ask about, and talk about treatment costs.

Doctors blast cost of cancer treatment

“With the cost of some lifesaving cancer drugs exceeding $100,000 a year, more than 100 influential cancer specialists from around the world have taken the unusual step of banding together in hopes of persuading some leading pharmaceutical companies to bring prices down.”

Life, Interrupted: The Cost of Cancer

How Do I Maximize My Health Insurance for Cancer Treatment?

A diagnosis of cancer is not something most people plan for; newly-diagnosed patients must work within the framework of their existing health insurance coverage. Insured Americans are covered by either private or public plans; private insurance may be within a group policy provided by an employer or an individual policy purchased on the open market. Public insurance is government-funded health insurance, such as Medicare or a state high-risk insurance policy. Regardless of the type of plan, all patients must manage co-pays, coinsurance and premium costs, and meet out-of-pocket expenditures. The range of formulas varies widely, so it’s crucial to scrutinize your plan at diagnosis…”


Financial Toxicity in Cancer-is MSK rationing cancer care?

Cudos to MSK Oncologists below for Working to Reduce the Financial Toxicity Caused by Expensive Chemo that Is No More Effective Than Current Standard-of-Care 

The NYT’s Op-ed piece linked below talks about a chemotherapy for colorectal cancer, several key issues raised in the article apply to any/all cancers and therefore need to be understood. I want to thank the authors, two oncologists from Memorial Sloan-Kettering, for writing this article. Even though these two oncs are paid consultants for Genentec, seller of Avastin, the current standard of care for colorectal cancer, I think that debating the issues raised by the two oncs in this op-ed article outweighs the presence of bias on their part.

1) “The drug, Zaltrap, has proved to be no better than a similar medicine we already have for advanced colorectal cancer while its price — at $11,063 on average for a month of treatment — is more than twice as high. (Than the current standard of care)

Even though Zaltrap has been approved by the FDA and can therefore be prescribed by medical doctors, studies indicate that this chemo is no more effective than the current therapy and costs more than twice as much as Avastin.  The FDA’s job is to gauge “safety and efficacy” and nothing more or less. Each and every cancer patient must ask his/her oncologist if the prescribed therapy is safe and more effective that similar therapies-“is chemotherapy X more effective than any other chemotherapies out there?”

2) Overall survival versus event-free survival- “In patients with advancing, metastatic colorectal cancer, the new drug, approved by the F.D.A. in August and jointly marketed by Sanofi and Regeneron, offers the same survival benefit as Genentech’s Avastin, which works through a similar molecular mechanism. When compared with the standard chemotherapy regimen alone, adding either medicine has been shown to prolong patient lives by a median of 1.4 months.”

Overall survival” means longer life.  Does a therapy, on average, mean the patient will live longer? “Event-free survival” means the time to the cancer’s progression.  A therapy can put you in remission for a longer average period but not help you live longer- on average.

3) “Consider that colorectal cancer is typically diagnosed in older individuals and the cost issue becomes starker still. Many patients are on Medicare and living on fixed incomes. And because Medicare requires patients to co-pay for cancer drugs, 20 percent of the cost of drugs like Zaltrap and Avastin is passed on — absorbed either by supplemental insurance or by the patients themselves.”

Cancer care is expensive even with medical insurance. If you have a 20 percent co-pay of the cost of drugs, you will be billed for 20% of all of your chemotherapies- potentially thousands of dollars.

“The burden of this cost is borne, increasingly, by patients themselves — and the effects can be devastating. In 2006, one-quarter of cancer patients reported that they had used up all or most of their savings paying for care; a study last year reported that 2 percent of cancer patients were driven into bankruptcy by their illness and its treatment. One in 10 cancer patients now reports spending more than $18,000 out of pocket on care.

Is MSK rationing cancer therapy? Yes.  But it is doing so by making the decisions that cancer survivors and caregivers need their oncologist to make. Why is finding the best cancer care for the least money a bad thing?


Recommended Reading:


In Cancer Care, Cost Matters

“AT Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.

The reasons are simple: The drug, Zaltrap, has proved to be no better than a similar medicine we already have for advanced colorectal cancer, while its price — at $11,063 on average for a month of treatment — is more than twice as high….”

Leave a Comment:

2 comments
Ronald Quasebarth says a couple of years ago

How do I get help with the incredible costs of cancer drugs? I have medicare and my Part D provider Humana seems good, will they have someone to help me navigate through this? Anybody else? Could I just stick to an old drug like Revlimid? Thanks, much!

Reply
    David Emerson says a couple of years ago

    Hi Ron- Several things. First, as for any help offered by Humana, you will have to check with them- look for “patient navigators” or titles like that.

    Secondly, there are drug manufactures that offer reduced pricing on some meds. This will depend on your financial situation but it’s worth a try.

    Thirdly, several non-profits offer financial assistance. I believe the Leukemia, Lymphoma Society has a program among others.

    Lastly, as I mentioned in Beating Myeloma, low-dose Revlimid until remission, more, another remission, etc, etc. may be your best therapy plan for the early stage MM patient.

    David Emerson

    Reply
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