Costly Cancer Medications: Not Easy to Access or
Afford in U.K. or U.S. - Even with Medicare
For 7 of 11 expensive cancer drugs, British
patients pay no out-of-pocket costs; U.S. patients, even with Medicare,
pay out $1,200 to $24,000 – uninsured pay even more
By Amy Sutton, Contributing Writer, Health Behavior News Service
Dec. 18, 2009 - Cancer patients in both the United
States and the United Kingdom face challenges in gaining access to
expensive cancer treatments, according to research published in the December
issue of The Milbank Quarterly.
“There seem to be a lot of generalizations as to
the worse availability of such drugs in the United Kingdom, compared to
the United States,” said study co-author Kalipso Chalkidou, M.D.
“We
wanted to take a serious look at what claims one can make based on
evidence rather than preconceived ideas.”
Chalkidou is director of the international program
at the National Institute for Health and Clinical Excellence in London.
She and U.S.-based lead author Ruth Faden, Ph.D., at the Johns Hopkins
Berman Institute of Bioethics, compared the cost and availability of 11
drugs used to treat a variety of cancers, focusing on those costing
between $8,700 and $32,000 for a three-month supply.
U.K. - For seven of the 11 expensive cancer drugs
examined, British patients pay no out-of-pocket costs.
U.S. - In comparison,
U.S. patients, even those with Medicare coverage, pay out-of-pocket
costs ranging from $1,200 to $24,000, depending on the length of their
treatment.
U.S. patients without insurance pay even more, and
because cancer patients often take more than one drug, their
out-of-pocket costs could soar higher, the authors reported.
However, for the other four drugs in the study, the
U.K.’s National Health Service pays nothing, whereas U.S. Medicare plans
offer at least some coverage for all 11 drugs.
Chalkidou noted that lack of reliable data made it
difficult to conduct meaningful comparisons on price, access and
affordability for U.S. and U.K. cancer patients.
“Both systems have to make tough choices and
neither is perfect. However, based on our analysis, it seemed to us that
the way decisions are made in the United Kingdom tends to be more
predictable, consultative and transparent than in the United States,”
she said.
In the United Kingdom, national and local
governments and clinicians use published criteria to make judgments
about covering the costs of treatment with expensive cancer drugs.
“Treatment for American cancer patients, on the
other hand, often depends not on the government or doctors’ decisions,
but on their health insurance coverage and their personal financial
resources,” the authors wrote.
“It’s important to see that there are strengths and
weaknesses to all allocation systems —either public or private,” said
Kevin Schulman, M.D., an expert in economic evaluation in clinical
research and professor of medicine and business administration at Duke
University. He has no affiliation with the study.
“There are different social constructs underlying
these two systems. The British clearly struggle with the potential for
people to have more access than is equitable. In the United States, we
accept this inequity without question, and then struggle with its
consequences,” Schulman said.
Source: Health Behavior News Service, part of the
Center for Advancing Health,
http://cfah.org.
To view the original study on Wiley-Blackwell’s
website, freely accessible to all visitors until March 2010,
click here. For copy in pdf:
click here.
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Dec. 18, 2009 - Cancer patients in both the United
States and the United Kingdom face challenges in gaining access to
expensive cancer treatments, according to research published in the December
issue of The Milbank Quarterly.
Extensive study finds cancer patients can fall in
drug program’s ‘donut hole’ almost immediately
