A new study from the University of Texas MD Anderson Center in Houston finds that breast cancer chemotherapy costs in the United States can vary by tens of thousands of dollars. Depending on the course of treatment your oncologist selects, even among regimens that achieve much the same effect, insurers’ cost for breast cancer treatment can vary as much as $20,000. This study was conducted among patients with insurance, and there was a smaller differential in their out-of-pocket costs, “but there still was a high financial burden for patients,” said Dr. Sharon Giordano, the lead author of the study.
Dr. Giordano found, for example, that swapping a commonly used three-drug regimen called TAC for dose-dense doxorubicin and cyclophosphamide cut as much as $15,000 from breast cancer treatment costs before insurance. "If there are equal options, it does seem like we should consider, potentially, the cost," she noted, as there is no evidence that one treatment is better than the other.
In Dr. Giordano’s study, the investigators reviewed the National Comprehensive Cancer Network guidelines for 12 regiments recommended for use in the adjuvant setting for HER2-negative breast cancer and nine more for HER2-positive breast cancer.
These were the estimated average chemotherapy costs to a breast cancer patient over the initial 18 months of care:
- $2724 – with 10% paying more than $7041 for chemotherapy without trastuzumab
- $3381- with 10% paying more $8384 for chemotherapy with trastuzumab
- $5158 for patients on high-deductible plans
Especially with high-deductible insurance plans, the cost of breast cancer treatment can put an extreme financial burden on women and their families. And unfortunately, it can be difficult for both doctor and patient to know how much breast cancer treatments will cost in advance of the treatment being billed to insurance. But even as studies like this come out, expenditures for cancer care are only the rise. Average costs have spiked from $72 billion in 2004 to $125 billion in 2010 and are estimated to reach $158 billion by 2020, according to Giordano’s team.
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| Average costs of cancer treatment are already large and are projected to grow to $158 billion by 2020. Source: cancer.gov |
Dr. Giordano concludes in her study that she and other oncologists need to realize the impact of the treatments they prescribe to patients and to research these costs for their patients. Better-informed patients can more skillfully discuss their treatment with their doctors and make decisions that make sense for their health, both in the traditional and financial sense.
