Key takeaways:
- Excessive-cost immunotherapy was related to elevated probability of being unable to afford medical care and taking fewer drugs resulting from value.
- Blood most cancers survivors expertise larger monetary hardship.
Most cancers survivors who obtained high-cost immunotherapies seem extra prone to expertise monetary hardship, in keeping with research outcomes printed in Journal of Most cancers Survivorship.
Monetary hardship, together with debt, incapability to afford medical care and taking fewer prescribed drugs resulting from value, was significantly of concern amongst blood most cancers survivors, findings confirmed.
Knowledge derived from Owsley KM, et al. J Most cancers Surviv. 2025; doi:10.1007/s11764-025-01797-2.
Kelsey M. Owsley
“Total, the outcomes had been largely in keeping with our speculation that high-cost immunotherapy medicine can be related to larger monetary hardship,” Kelsey M. Owsley, PhD, MPH, assistant professor at Fay W. Boozman Faculty of Public Well being at College of Arkansas for Medical Sciences, instructed Healio.
“One notable discovering was that this impact was primarily pushed by sufferers with blood cancers,” she added. “Once we appeared extra carefully, we discovered a hanging distinction in median immunotherapy prices between sufferers with stable tumors and people with blood cancers — $993 vs. $7,578. This implies that most cancers sort is a crucial consideration when evaluating the monetary impression of high-cost remedies.”
Healio beforehand reported on the extent of economic hardship in survivorship, with research outcomes exhibiting that youthful survivors and people with Medicare or Medicaid insurance coverage are significantly weak.
One other research confirmed that whereas nearly all of sufferers with most cancers need to have conversations about prices of care, fewer than 15% of sufferers report having such conversations with their care crew.
Owsley and Cathy J. Bradly, PhD, MPA, dean of the Colorado Faculty of Public Well being and deputy director of the College of Colorado Most cancers Heart, used knowledge from the 2010 to 2020 Well being and Retirement Research to analyze the affiliation between monetary hardship and receipt of high-cost immunotherapy amongst most cancers survivors.
The research pattern included 409 most cancers survivors aged 65 years and older (59% ladies; 85% white) who had been nonetheless alive a minimum of 3 years following most cancers therapy. Eligible sufferers had obtained infusion and oral immunotherapy by means of Medicare Half B or D from 2010 to 2018.
Indicators of economic hardship, together with debt, incapability to keep away from medical care, decreased medicine use resulting from value and excessive out-of-pocket bills, served as main outcomes. Researchers targeted on the affiliation between these elements and newer immunotherapies, that are growing in use and price.
Outcomes confirmed {that a} third (33.3%) of the pattern reported debt, 4.7% couldn’t keep away from medical care and 13.9% decreased their medicine use resulting from value. Almost half (47.6%) of the pattern had out-of-pocket bills that exceeded a minimum of 10% of their family earnings.
A few quarter (27.4%) of survivors had obtained a high-cost immunotherapy agent.
Survivors who obtained high-cost immunotherapy had been considerably extra prone to not be capable to afford medical care (8% vs. 3.4%; P = .047) and to take fewer prescribed drugs (19.6% vs. 11.8%; P = .041).
In contrast with survivors of stable tumor cancers, blood most cancers survivors had been extra prone to report debt (40.5% vs. 31.6%), not be capable to afford medical care (9.5% vs. 3.6%) and take fewer drugs (28.4% vs. 10.7%).
Multivariable linear likelihood fashions confirmed that high-cost immunotherapy correlated with a 7.2 proportion level (95% CI, –0.011 to 0.156) elevated probability of not having the ability to afford medical care.
Amongst blood most cancers survivors, high-cost immunotherapy was considerably related to a 23.8 proportion level (95% CI, 0.013-0.463) larger probability of not having the ability to afford medical care and a 42.7 proportion level (95% CI, 0.148-0.706) larger probability of taking fewer drugs.
Survivors who had been youthful, non-white, Hispanic, in fair-to-poor well being and who had a excessive variety of comorbidities appeared extra prone to obtain high-cost immunotherapy medicine.
The truth that non-white and Hispanic most cancers survivors had been extra prone to obtain high-cost immunotherapies contradicts prior analysis, in keeping with Owsley.
“This was surprising, provided that earlier analysis has usually discovered that racial and ethnic minorities face larger boundaries to accessing therapy,” she instructed Healio. “We suspect this will likely mirror variations in most cancers stage or severity at prognosis, however sadly, our knowledge don’t embrace detailed scientific data to verify that.”
Researchers acknowledged research limitations, resembling not together with inpatient claims, a small pattern measurement of blood most cancers survivors, solely together with survivors who obtained therapy and never accounting for confounding elements resembling most cancers stage.
“Whereas high-cost immunotherapies can supply improved outcomes, it’s vital to acknowledge that they might additionally enhance monetary hardship for most cancers sufferers and probably lead some to delay or forgo wanted care,” Owsley instructed Healio. “These findings spotlight the significance of proactively connecting sufferers to monetary navigation providers, particularly these receiving costly remedies. Supporting sufferers in managing the price of care needs to be thought-about a key a part of high-quality most cancers therapy.”
Owsley and colleagues proceed to analyze elements driving medical debt, together with variation in most cancers therapy prices and coverage choices that affect these variations.
“There have been plenty of current coverage conversations round drug worth caps and negotiations,” Owsley mentioned. “I feel it’s vital to notice that early proof suggests the Biden administration’s Medicare drug worth negotiations, approved underneath the Inflation Discount Act, have already led to cost reductions for some drugs.
“Trying forward, high-cost immunotherapies could possibly be prioritized for future negotiation, which can assist scale back the monetary burden for Medicare beneficiaries receiving these remedies,” she added.
For extra data:
Kelsey Owsley, PhD, MPH, could be reached at kmowsley@uams.edu.
