Renal Cell Carcinoma: Cost of Treatment May Negate Impact of Treatment Advances
A new study adds to the growing body of evidence that insurance status and high out-of-pocket costs can pose serious financial barriers to cancer treatment, limiting access to therapies and, consequently, increasing the potential for negative consequences for overall survival.۱
The study by researchers at the University of Pennsylvania and the Fox Chase Cancer Center in Philadelphia focused on 1721 Medicare patients with metastatic renal cell carcinoma (mRCC). It found that almost 40% fewer with high out-of-pocket costs initiated oral therapy compared with those with low out-of-pocket costs.
“This is especially relevant for the treatment of metastatic renal cell carcinoma,” they wrote, because of the discovery of many new, but expensive, oral therapies available to mRCC patients.
“These expanded treatment options have demonstrated reduced toxicity and been shown to extend survival in clinical trials, more than doubling the median overall survival of approximately 1 year conferred by pretargeted era therapies.”
The study compared the treatment initiation rates of Medicare Part D patients who received low-income subsidies (LIS beneficiaries) to their non-LIS counterparts. The difference in out-of-pocket costs was significant: at least $2800 for the initial oral prescription for non-LIS patients, compared with $6.60 or less for subsidized patients.
Barely one 1 of 5 patients with the higher out-of-pocket costs (20.7%) initiated oral therapy, whereas more than a third of the LIS patients did (33.9%). The non-LIS patients, furthermore, demonstrated lower rates in initiating any targeted therapies (26.7% vs 40.4%).
Even when they did initiate treatment, the authors wrote, “non-LIS patients were also slower to access therapy.”