Patients bear brunt as cancer care spending hits $90 billion

Updated 8m ago |
By Liz Szabo, USA TODAY

The cost of cancer treatment is "skyrocketing" — both for individual patients and the nation, a new analysis shows.

From 1990 to 2008, spending on cancer care soared to more than $90 billion from $27 billion. The increase was driven by the rising costs of sophisticated new drugs, robotic surgeries and radiation techniques, as well as the growing number of patients who are eligible to take them, says Peter Bach of New York's Memorial Sloan-Kettering Cancer Center, co-author of an analysis in today's Journal of the American Medical Association.

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Many older, frailer patients — who might not have been considered strong enough to weather traditional surgery — now have the option to have less invasive operations or more tightly focused radiation treatments, the analysis says.

More of these patients also are able to have chemotherapy, both because of new treatments as well as "supportive" drugs to manage chemo's side effects, such as nausea.

From 1991 to 2002, for example, the proportion of breast cancer patients receiving chemotherapy doubled, to about 24%. The cost of care for each patient also doubled, from $6,642 to $12,802, the analysis says.

Those increases are "unsustainable," says John Seffrin, chief executive officer of the American Cancer Society, who wasn't involved in the study.

"Growing numbers of people simply can't afford to get the care we know they need," Seffrin says. "We hear about a growing number of people turning down treatment."

Charities are struggling to keep up with requests for help. In the past, the American Cancer Society could help one in five patients pay for health care bills. Today, the society can help only one in six, says Seffrin, who notes that the poor economy only adds to cancer patients' hardships.

The social service group CancerCare helped 13% more people in 2009 than the year before and distributed nearly $4.4 million. Both CancerCare and American Cancer Society have set up organizations to help insured people with co-pays.

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 by USA TODAY, the Kaiser Family Foundation and the Harvard School of Public Health.

A spate of new drugs for advanced colorectal cancer also has helped patients live slightly longer but at great cost, says David Howard of Emory University, author of a new study in the Archives of Internal Medicine.

Drugs approved in the past decade extended these patients' survival in 2005 to about 16 months — an improvement of 7 months — at an additional cost of $37,100 a patient, the study says.

Howard and Bach agree that doctors and drug companies today have no incentive to lower prices.

Cancer specialists can make more money by prescribing more expensive drugs, Bach says. Studies show that doctors who are "generously" reimbursed tend to prescribe more costly therapies.

The use of hormone-suppressing drugs for prostate cancer, for example, fell 14% in just two years after Medicare slashed what it was paying doctors, according to a 2008 study in Cancer.

"Right now, there are no economic incentives to use resources wisely," Bach says.

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