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!
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Earth Sciences
24.03.2017 | Health and Medicine
24.03.2017 | Earth Sciences