Using data from health plan claims for the anti-cancer drug imatinib filed between 2002 to 2011, Stacie B. Dusetzina, PhD, research professor at the UNC School of Medicine and Gillings School of Global Public Health and member of the UNC Lineberger Comprehensive Cancer Center, found that patients with higher co-payments were 70 percent more likely to stop taking their cancer treatment and 42 percent more likely to skip doses.
The study, published by the Journal of Clinical Oncology is one of the first to examine the effect of high out-of-pocket drug costs for targeted cancer therapies on patients.
Dusetzina, along with colleagues from UNC, Harvard and the Dana-Farber Cancer Institute, used health plan claims from privately-insured adult patients (ages 18 to 64) from 2002 and 2011 to examine the relationship between out-of-pocket costs for imatinib, marketed under the trade name Gleevec in the United States, and patient adherence. The data showed that insurance co-payments for imatinib ranged from nothing to $4,792 for a 30-day supply of the medicine, with the costs increasing over the study years.
Imatinib is one of the major success stories of modern pharmaceutical development. Before the development of the drug, a patient with the white blood cell cancer chronic myeloid leukemia (CML) had a grim prognosis, with only 30 percent surviving more than five years after diagnosis.
With the advent of imatinib, the five-year survival rate rises to 89 percent so long as patients adhere to the prescribed treatment plan. Evidence suggests that patients missing even 15 percent of prescribed doses can relapse, as the cancer develops resistance to the drug.
"Imatinib is an expensive drug, but it is a great example of a drug where there is not a lot of confusion about which patients will benefit. Most patients with CML will benefit. However, individuals need to take it almost perfectly, and not taking it can have severe medical consequences," said Dusetzina. "So maximizing adherence is crucial."
The data used in the study only included patients on employer-based plans. Most individuals had low out-of-pocket costs - the most common cost was $30 for a 30 day supply, but copayments and co-insurance amounts required of patients varied substantially.
"We studied people who are part of large employer groups, so their insurance is probably more generous than someone who is buying insurance on a private market that does not have a lot of negotiating power," said Dusetzina.
Monthly co-payments for imatinib from patients in data used by the study averaged $55 in 2002 and $145 in 2012, with 6.4 percent paying more than $500 a month. The combined monthly costs of the drug to the insurance company and patient increased from 2,798 to $4,892 over the same period. The data did not include patients who were not able to afford to pay to begin taking the drug, which leads Dusetzina to believe that the study underestimates the effects of drug costs on adherence.
"If you went to the pharmacy to obtain your prescription and they said it was $5,000 and you walked away because you couldn't afford to pay, you're not in the data; we could only study individuals who filled at least one prescription," said Dusetzina.
Dusetzina said that the data has implications beyond imatinib. The cost of many new pharmaceuticals for rare conditions can cost insurers and patients more than $100,000 year.
"Our results are particularly relevant for specialty pharmaceutical products, those that cost over $10,000 a month, however, the lessons learned likely relate to any pharmaceutical product that has high out of pocket costs," said Dusetzina. "It is important that we identify strategies to make effective but expensive medications more affordable to patients."
William Davis | EurekAlert!
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology