Study: Why nonelderly patients may be more likely to change their cancer drugs

Oncologists should proactively discuss costs, some say

Cancer patients under age 65 are more likely than those without cancer to change the way they use prescription drugs because of financial reasons, according to a study published Monday in the journal Cancer.

The findings come amid industry scrutiny regarding increasing prescription drug costs, which the researchers wrote could cause cancer patients to "delay, skip, or even forgo their prescription medications for financial reasons."

Study details

The study was based on data from the 2011-2014 National Health Interview Survey. It included responses from 8,931 cancer patients and 126,287 individuals without a history of cancer. Patient data was further divided into two groups:

  • Elderly, age 65 and older; and
  • Nonelderly under age 65.

The researchers examined survey responses to identify factors that they attributed to financial-related changes in prescription drug use, including:

  • Asking a physician for a lower-cost drug;
  • Delaying filling a prescription;
  • Purchasing medication from another country;
  • Skipping doses;
  • Taking less of a medication than prescribed; and
  • Using alternative therapies.

Findings

The researchers found that about one-third of cancer patients under 65 changed the way they took medication because of cost.

Among nonelderly adults, the researchers found 31.6 percent of recently diagnosed cancer patients and 27.9 percent of cancer patients who had been diagnosed for at least two years reported financial-related changes to the way they took their medications, compared with 21.4 percent of adults without a history of cancer.

Specifically, the researchers found nonelderly cancer patients were more likely to delay filling a prescription or to use alternative therapies when compared with adults who did not have a cancer diagnosis. The likelihood of not taking medications as prescribed increased among cancer patients with several comorbid conditions, according to the study.

The researchers did not find similar differences in prescription drug use between elderly cancer patients and elderly patients who were not diagnosed with cancer, which the researchers wrote likely is the result of "near-universal coverage" for the two groups through Medicare.

Implications

The researchers said the findings have implications for providers and health care policy.

They said medical oncologists need guidance on how to discuss treatment costs with patients and how to factor the cost of care into treatment decisions, while primary care physicians who help coordinate care "may want to consider the overall financial burden of prescription drugs."

Further, the researchers wrote that lawmakers should ensure health care policies intended to ease the financial burden of cancer-related drugs "target [cancer patients] who have multiple comorbid conditions and high-deductible health plans." The researchers did not have complete information on individuals' health insurance premiums, copayments, or coinsurance, but they noted that cancer patients enrolled in a high deductible plan were more likely than those with a low deductible to request  less costly versions of their medications.

Dr. Jha 'rolled the dice' on his health to save money. Here's how it changed his view on high-deductible plans.

Separately, Daniel Goldstein of the Rabin Medical Center in Israel and the Winship Cancer Institute at Emory University in an accompanying editorial wrote, "Financial toxicity is now a well-established and generally accepted toxicity related to cancer care." He added, "When two different treatments exist with equivalent efficacy and safety, the cheaper treatment should always be chosen" (Jenkins, MedPage Today, 2/21).

What they value: Five types of cancer patients

Cancer patients have more choices for their care than ever before. To attract patients in this fiercely competitive landscape, you must invest your limited resources in the right services—ones that will earn patients' trust and improve their experience.

Oncology Roundtable's analysis of our 2015 Cancer Patient Experience Survey revealed five distinct patient types—each with unique characteristics and preferences for their care. Our infographic is your guide to understanding the five types of patients and what they value in a cancer provider.

DOWNLOAD


Next in the Daily Briefing

A GOP ACA replacement draft bill leaked. Here's what we know.

Read now