Tag: Cancer

Federal drug discount program likely hurts cancer patients
Almost half the hospitals in the U.S. that treat Medicare patients, participate in the federal government’s 340B program, designed to provide discounts to safety net health providers and increase services to underserved patients. Through participation in the program, hospitals save as much as 25 to 50 percent on outpatient drug costs so that they can provide more services and/or provider more charity care and serve more patients. The GAO and others have found this federal drug discount program likely hurts cancer patients and increases Medicare costs.

One recent study found that the majority of 340B hospitals provide less charity care than the national average. It also appears that the drug companies make money off 340B programs even though the program requires substantial discounts on cancer drugs by raising prices more than the discounts offered.

Specifically, the GAO report found that per person cancer drug spending for people with Medicare was more than twice as high in 340B hospitals than in non-340B hospitals. And, from this, GAO concluded that 340B hospitals either prescribe more cancer drugs or more expensive drugs than non-340B hospitals. This is not surprising given that the 340B program provides hospitals a financial incentive to spend more on cancer drugs; the 340B program is a profit center for them.

The GAO raises three main concerns: 1. How to ensure the 340B hospitals are providing appropriate treatment to cancer patients; 2. How to protect these cancer patients from being liable for higher drug copays than they should be paying because their drug costs are higher? and 3. How to reduce unnecessary Medicare spending?

HHS, which oversees the 340B program suggests that patient outcomes may differ–and may be better–in the 340B programs. But, the GAO concludes otherwise.

Here’s more from Just Care:
October 11, 2016
Death rate up in U.S., though fewer dying of cancer
New CDC data show that the death rate is up in the U.S in 2015 to almost 2.6 million. The number of deaths (age-adjusted) rose from 723.2 deaths in 2014 to 729.5 per 100,000 last year. With the exception of the death rate for cancer, which has fallen slightly, death rates for most other chronic conditions are rising. Still, there are many more births—4 million births in the U.S. in 2014, up 1 percent from 2013—than deaths.

Here’s some age-adjusted data:
- More older adults are dying from falls, up from 58.7 to 59.8 deaths per 100,000
- More people are dying from suicides, stroke, emphysema, drug overdoses and Alzheimer’s disease
  - Stroke: Up from 36.4 to 37.4 deaths per 100,000
  - Suicides: Up from 12.7 to 13.1 deaths per 100,000
  - Emphysema and chronic bronchitis: Up from 40.1 to 41.3 deaths per 100,000
  - Drug overdose: Up from 14.1 to 15.2 deaths per 100,000
  - Alzheimer’s disease: Up from 25.4 to 29.2 deaths per 100,000
- Rates of death linked to heart disease, diabetes and kidney disease have not changed
  - Heart disease: Only slightly up from 166.7 to 167.1 deaths per 100,000
  - Diabetes: Only slightly up from 20.9 to 21.1 deaths per 100,000
  - Kidney disease: Very slightly up from 13.2 to 13.3 deaths per 100,000
- Fewer people are dying from cancer, down from 160.9 to 157.9 deaths per 100,000
Here’s more from Just Care:
June 9, 2016
Spying on cancer

What if a new technology could detect aggressive cancer cells, effectively spying on cancer? Researchers think it could improve the chances of treating these cancers.

Some cancers are aggressive and fast-growing, requiring equally aggressive treatment. Most cancer deaths are caused by cancer that’s metastasized, or spread from the original location to enter the bloodstream and pop up in other, cancer friendly locations. Others are what H. Gilbert Welch calls “turtles”: slow moving and maybe not needing painful and debilitating treatment right away.

We are on the cusp of being able to “spy” on cancer cells and actually see how they break off from a tumor and enter the bloodstream. And, that’s great news for people with aggressive cancers. Here is a video released by the NCI (National Cancer Institute) that shows, in live time, breast cancer cells breaking from the tumor and entering the bloodstream.

https://www.youtube.com/watch?v=IvyJKrx5Xmw

This article was originally posted on Medshadow.org. To read the rest of this article, visit the Medshadow Foundation.

To read about high-tech goggles that allow people to see cancer cells, click here.

February 9, 2016
Majority of cancer drugs that FDA has recently approved don’t work

According to a new study in JAMA, there is no evidence that the majority of the U.S. Food and Drug Administration (FDA) approved cancer drugs over the last five years work. The FDA used substitute measures, laboratory measures rather than clinical evidence, to approve two out of three cancer drugs, without any indication that the drugs either improve health or prolong life. Indeed, in follow-up studies, 86 percent of drugs approved through substitute measures showed no clinical benefits.

In the case of bevacizumab, a breast cancer drug treatment, the FDA allowed the drug to go to market based on substitute measures that showed “progression-free survival” or PFS. But, a later study showed substantial toxicity and no improvement in life expectancy. And, the FDA ended up removing authorization to market it.

In 2009, the U.S. Government Accountability Office took the FDA to task for failing to do postmarketing studies on all drugs that are approved using substitute measures. The GAO reported that the FDA had plans to improve oversight, but it was not prepared to say whether those initiatives would be effective. According to the GAO, there are no specific conditions that require the FDA to speed up the withdrawal of a drug from the market if a drug company does not conduct a follow-up study in a timely manner or if a drug is shown not to be beneficial in a follow-up study.

The drug companies prefer getting drug approvals using substitute measures that do not focus on efficacy or health outcomes. Substitute measures allow drug companies to bring drugs to market faster and at less cost. When the drug companies use clinical measures that look at health outcomes, they must spend more time and money on their trials.

The problem is that substitute measures may show good performance when in fact health outcomes are not any better. Health complications may also not be evident through the substitute measures. So, drugs approved using substitute measures may actually hurt patients.

The price of a new cancer drug can easily be $10,000 a month, regardless of either the drug’s worth or its cost of development. The cost of cancer drugs can literally bankrupt a person with cancer. In 2014, the least expensive new cancer drug approved cost more than $120,000 a year.

Today, the drug industry helps cover the cost of the FDA’s work. And, we are left to wonder whether the FDA’s independence has been compromised at the expense of patient safety. At the same time, the public may wrongly assume that FDA approval means the drugs are safe.

Here’s a short post on how Congress leaves insured Americans at the mercy of the drug industry. Top 20-selling drugs in the U.S. are now three times more than the in the U.K. And, here are six tips for keeping your drug costs down, along with five programs that could lower your costs if you have Medicare. And, for other free and low-cost assistance programs, click here.

October 30, 2015
Hi-tech goggles allow doctors to see cancer cells

In the what-will-they-come-up-with-next department, a new goggle technology allows doctors to see cancer cells. They literally light up. Watch for yourself. And, then, see how the pharmaceutical industry is hiking up the cost of cancer drugs astronomically. It could bankrupt you!

August 28, 2015
Unite with doctors to advocate for lower cancer drug prices

Last week, in an article for Mayo Clinic Proceedings, a group of 118 distinguished doctors united to question the pricing of cancer drugs, which is “unsustainable,” and to call for a new pricing method. As this 60 Minutes report reveals, the drug companies set the price of cancer drugs as high as they can. And because of their market power, cancer drug prices have risen an average of $8,500 a year for the last 15 years, a five to ten-fold increase in the price of new cancer drugs over that period.

One in three Americans will have some form of cancer. And, even with insurance, they typically will end up bearing 20 to 30 percent of the cost of their cancer drugs. The insurers have no ability to rein in prices so insurers simply shift more drug costs to their members. People who need a new cancer drug easily could end up with out-of-pocket annual costs of $30,000 just for their cancer medication. Worse still, they might have to forego needed treatment. In 2014, the least expensive new cancer drug approved cost more than $120,000 a year.

American households have an average gross income of $52,000. And half of people over 65 have incomes under $23,500. When out-of-pocket costs for cancer medications are anywhere near $20,000 a year, most people will need to sell assets or take out loans to pay for the drugs; $20,000 represents half of the take-home pay of a typical working family and slightly less than the average income of older adults.

Not surprisingly, as many as one in five cancer patients today are not taking their cancer treatments or taking less than the amount they need. They and their families are suffering and some are needlessly dying. The doctors argue that something has to change.

The doctors offer several possible solutions, including Medicare drug price negotiation, which is the top policy priority for Americans. They also suggest legislation that would prevent pharmaceutical companies from paying generic drug companies to delay putting generic drugs in the market at lower prices and/or that would allow Americans to import drugs from abroad at lower prices. Click here to read their other proposed solutions.

If you agree that we need federal action to stop these high cancer drug prices, email [email protected] or click here, and we will add your name to the campaign list. In the meantime, if you’d like some tips for keeping your drug costs down, click here.

July 28, 2015
Insurers may be ready to support negotiated drug prices

Cancer drug prices keep rising, up from an average of $129 a month in 1975 to an average of over $10,000 a month in 2010. These drugs are increasingly unaffordable, even with insurance, because the insurance companies keep hiking up the copays. In a new twist designed to keep prices sky high and generate greater revenues, the drug companies are attacking health insurers and allying with cancer groups to advocate for lower copays. It could be the drug companies’ undoing; insurers may be ready to support negotiated drug prices.

You would think the drug companies would be embarrassed by the obscene cancer drug prices they are charging. (Express Scripts says that almost one-third (32 percent) of all health insurer spending on drugs came from one percent of prescriptions for costly specialty drugs.) You would want these drug companies to charge US residents what they charge residents of every other wealthy nation. Instead, they are effectively arguing that everyone with health insurance should pay higher premiums and deductibles.

If insurance companies were to reduce copays for cancer drugs, there’s no question they would simultaneously increase premiums, deductibles and perhaps copays for other services. More people might be able to afford cancer drugs. But, fewer people would be able to afford insurance premiums, deductibles and other health care services.

Right now, four states limit drug copays to no more than $150 a month. And, with Pfizer’s lobbying support, many other states are considering similar limits. But, as Karen Ignagni, head of the health insurers’ trade association explains, “it’s a shell game that’s being played on consumers.” Patients, state governments and employers all end up paying higher health care costs as a result of these caps.

To date, the health insurance industry has not shown any willingness to ally with patients to push for negotiated drug prices. Rather, the drug companies and the health insurers have been allies. Perhaps, the drug companies’ behavior will finally move the insurers to do right by patients, take on the drug companies and argue for drug price negotiation. It’s about time they did. If they do, we would have the drug companies to thank!

April 9, 2015
The cost of cancer drugs: It could bankrupt you

If you want to understand the power of the pharmaceutical industry to gouge Americans and, in particular, to force Americans with cancer into bankruptcy, you should watch this 60 Minutes piece that aired on October 5, 2014.

October 26, 2014