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Even Insured Cancer Patients May Stumble Over Co-pays and Drug Costs

Even Insured Cancer Patients May Stumble Over Co-pays and Drug Costs

Financial assistance is available, but patients may need help negotiating the system.

Jeff Kranau’s story is a moving one but, during this economic downturn, not necessarily a unique one. The former South Florida salesman was successfully treated for squamous cell carcinoma of the larynx in 2009 and declared cancerfree. But what should have been a reason for celebration has, over time, sent Mr. Kranau’s life into a tailspin.

“I now have a permanent hole in my vocal cords from the radiation, which makes it quite difficult for me to project my voice any louder than a loud whisper. Part of my job involved taking potential sales calls and answering questions for customers over the phone,” Mr. Kranau told Oncology News International. “Obviously, I am no longer able to do that.”

Mr. Kranau eventually left his job and, subsequently, lost coverage for the multiple medications he needs to ease his postchemoradiotherapy complications. “Without insurance, I am in need of funds for help with medical bills and, most importantly, my medications, which I can no longer afford,” he said.

The ranks of the uninsured or underinsured have been on the rise, placing a burden on cancer patients and the programs that dispense treatment. A national poll conducted by the American Cancer Society Cancer Action Network found that, over the past two years, nearly one-half of cancer patients and survivors under age 65 said they are having difficulty affording healthcare costs, including paying for copays and prescription drugs (ACS CAN poll results, June 23, 2010).

As a result, one in three patients under age 65 diagnosed with cancer delayed needed cancer-related tests, treatments, checkups, and filling of prescription drugs over the past year.

  “We have been loath to send our patients to hospitals… Hospitals are our partners so we don’t want to put a financial burden on them.”
—Leonard Kalman, MD

 

Another survey by the Association of Community Cancer Centers (ACCC) found that patients over the past two years are increasingly asking treatment facilities for help with the cost of co-pays, prescription drug costs, and transportation.

“If you speak to oncologists, threequarters of the doctors in community practices in 2010 had seen the direct impact of the recession,” said Lee Blansett, senior vice president of Oncology Market Access for Kantar Health, based in Foster City, Calif. “Chief among those impacts was patients’ inability to pay for cancer treatments and, in some cases, an increasing number in whom treatment selection was based on the ability to pay.”

Mr. Blansett added that data prior to the recession were already showing a trend toward increased number of uninsured and underinsured patients, and he suggested that this trend will continue even if the recession is officially declared to be over.

TABLE 1 Sources of financial assistance: Nonprofit
 

• American Cancer Society Health Insurance and Financial Assistance
www.cancer.org/Treatment/FindingandPayingforTreatment/ManagingInsuranceIssues/ HealthInsuranceandFinancialAssistancefortheCancerPatient/index

• CancerCare
www.cancercarecopay.org/about.html

• Chronic Disease Fund
www.gooddaysfromcdf.org/patients/process

• Cancer Fund of America
www.cfoa.org

• Cancer Support Community/The Wellness Community
www.thewellnesscommunity.org/

• HealthWell Foundation
www.healthwellfoundation.org/

• Patient Advocate Foundation
www.patientadvocate.org

• Susan G. Komen for the Cure
www.komen.org

• Surgery on a Sunday
www.surgeryonasunday.org

• Life Beyond Cancer Foundation
www.lifebeyondcancer.org

 

Lee Blansett

Centralized support
For some independent practices, the most efficient way to manage uninsured or underinsured patients is to refer them to hospitals.

“Hospitals have more resources and revenue streams and therefore may also be better at organizing patient assistant programs,” Mr. Blansett said.

But that may place an undue strain on hospitals, which could come back to haunt a community practice that is in partnership with a larger facility. “We have been loath to send our patients to hospitals,” said Leonard Kalman, MD, an oncologist at Advanced Medical Specialties in Miami. “Hospitals are our partners so we don’t want to put a financial burden on them.”

 

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