Expensive Drugs Forcing Cancer Doctors To Weigh Price

Robert Langreth | Bloomberg | May 31, 2014

When oncologist Yousuf Zafar at the Duke Cancer Institute prescribed an expensive pill for a young man with colon cancer two years ago, he assumed his patient could afford it because he had a job and private insurance. Eight months later, Zafar was about to prescribe the drug a second time to the man, whose cancer had relapsed. This time, though, he was shocked when the patient told him his co-pay was $325 per week -- and he couldn’t afford it much longer.

With “one simple question, I could have saved him thousands of dollars, and distress,” said Zafar, who switched the man to an equally effective injected drug with no co-pay.

With new cancer drugs priced as high as $10,000 a month and more, and insurers tightening payment rules, patients who thought they were well covered increasingly find themselves having to make life-altering decisions about what they can afford. As a result, cancer doctors trained to weigh side effects and efficacy are being regularly pulled into delicate discussions on cost, an issue that will be explored at the American Society of Clinical Oncology meeting in Chicago through June 3. The group is working on an algorithm to rate the cost-effectiveness of oncology drugs to help doctors with those conversations...