The Cost of Cancer Treatment Impacts Prescription Drug Adherence

The rising cost of cancer treatment is negatively affecting prescription drug adherence, according to a recent study conducted by researchers at the American Cancer Society and published in the journal Cancer.

Patients with a history of cancer were more likely to stop or switch their treatment for financial reasons than patients with other diseases, according to the study, which used data from the National Health Interview Survey. Further, nonelderly cancer survivors were more likely than elderly cancer survivors to alter or stop their treatment, and nonelderly people with high deductibles are more likely to ask their physicians for a lower price than those who have a lower deductible.

Rising deductibles, copayments, co-insurance and tiered drug formularies all contribute to the increasing percentage of cancer care cost that patients must now pay for out of pocket. This can affect survivors’ overall wellbeing, lead to poorer treatment choices, have a negative effect on outcomes and cause higher medical expenses down the line, according to the study.

“I would encourage patients to discuss their financial concerns with their care providers when making treatment decisions,” Xuesong Han, Ph.D., strategic director, Health Policy and Healthcare Delivery Research at the American Cancer Society, and author on the study said in an interview with CURE.

The study found that 31.6 percent of recently diagnosed survivors (those who were diagnosed within the past two years) and 27.9 percent of patients previously diagnosed (two years ago or longer) reported a change in their prescription due to financial reasons. This is compared to 21.4 percent of people without a history of cancer.

“Nonelderly cancer survivors are particularly vulnerable to the risk of changing their prescription drug use for financial reasons, which may be explained in part by the complex relationship between employment and insurance coverage,” the article says.

While younger working-age patients may depend on their employment for insurance, elderly patients are typically covered under Medicare, which is likely a reason for their being less inclined to stop treatment due to money problems, the study says.

“We were a little bit surprised that among elderly population, we did not observe such systematic differences in reporting changes in prescription use for financial reasons between cancer survivors and individuals without a cancer history,” Han said.

“This is likely related to the near universal enrollment in Medicare,” she went on, “including prescription drug coverage for many, among the elderly population, and the fact that most elderly individuals without a history of cancer had two or more other chronic conditions, which may also require prescription drugs.”

The authors called for further studies that monitor cost-related medication adherence, especially as the Affordable Care Act changes.

“Health care policies that help cancer survivors address the financial burden of prescription drugs should target those who have multiple comorbid conditions and high-deductible health plans,” the study says.