One in eight people with advanced cancer turned down recommended care because of the cost, according to a new analysis from Thomson Reuters, which provides news and business information. Among patients with incomes under $40,000, one in four in advanced stages of the disease refused treatment.
Of late-stage colon cancer patients, 12% spent more than $25,000 out of pocket, according to the survey, in which 1,767 people answered an online questionnaire. This type of survey isn't considered scientifically rigorous, because it didn't use a random sample of people. But its findings are similar to a 2006 study in Cancer, which found that cost caused more than 20% of all cancer survivors — not just those with advanced cases — to delay or miss needed care.
Experts say the signs of stress are everywhere:
• Nearly 20% of Americans have problems paying their medical bills, according to a report in September from the Center for Studying Health System Change.
• One in four cancer patients or their families said they used up all or most of their savings to pay for treatment, according to a 2006 survey of nearly 1,000 survivors and their families by USA TODAY, the Kaiser Family Foundation and the Harvard School of Public Health.
• One in 10 in that survey said they were unable to pay for basic necessities, such as food, heat and housing.
Many of the medical advances that allow cancer patients to live longer come at a high cost, says Joseph Singer of HealthCore, a Delaware-based health research company.
As costs rise, insurers are shifting a greater share to patients, says Neal Meropol of Philadelphia's Fox-Chase Cancer Center. Many plans now require patients to pay for 20% of their health care — a heavy burden in the case of drugs such as Erbitux, which costs $10,000 a month.
Charities that assist cancer patients say they're straining to keep up with the demand.
At CancerCare, a national group that provides social work and small grants for transportation expenses, requests for financial help increased 30% this summer compared with last, says executive director Diane Blum.
David Johnson, director of hematology and oncology at Nashville's Vanderbilt-Ingram Cancer Center, says some of his patients have opted to stop treatment partly because of the cost. His own brother-in-law, a truck driver, turned down Erbitux when he was facing colon cancer four years ago. He says patients face a painful dilemma: "Do they pay out of pocket — sometimes in the thousands of dollars — or do they forgo the therapy to preserve for their family what modest assets they may have?"
source: http://www.usatoday.com/news/health/2008-10-12-cancer-costs_N.htm?loc=interstitialskip
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