Drug Costs Revisited

And the costs go onward and upward…..

 

I have written a blog or two (or more) about the high and still rising costs of prostate cancer (and other cancers, too) treatment drugs.Here is another one!

The list of current FDA approved treatments for prostate cancer is rather long. Some of the approved drugs have been around long enough to be generic and not nearly as expensive as the new drugs.

I googled the drug names and drug costs of a selected few of the newer ‘miracle’ drugs. I use the term ‘miracle’ advisedly here. In clinical trials some of the drugs provided an extended lifespan or symptom free time of only a few months. So I consider these drugs to be ‘small miracle’ drugs. We are still in an era of “one size fits all,” and all patients do not receive the same benefit from a particular drug.

Personal disclosure: I worked my way through the generic drugs and graduated to one of those zillion dollar miracle drugs. For the past several years my PSA and my side effects have been more or less under control—thanks to the new medication. I discovered in my searches it is sometimes hard to pin down the actual retail cost of these drugs. Numbers seem to vary slightly depending on what site you look at and what day it was updated, so the sample list I have compiled is more or less accurate. I have included the ball park average cost. These are the basic full price costs for a few selected drugs.

A few spendy drugs

1.      Abiraterone (Zytiga): Pills taken daily. Approximately $8,500 per month.

2.      Cabazitaxel (Jevtana): Injection every three weeks. Approximately $48,000 for one course of treatment—ten injections.

3.      Enzalutamide (Xtandi): Pills taken daily. Approximately $9,000 per month.

4.      Leuprolide Acetate (Lupron): Injection. Approximate cost of three month 11.25 mg injection is $6,800.

5.      Radium 223 Dichloride (Xofigo): injection (six treatments at four week intervals) $69,000 for six injections.

6.      Sipuleucel-T (Provenge): Injection, three infusions in one month. $93,000.

Paying the Piper

Most of us don’t (and couldn’t) pay that amount, of course. The average age for prostate cancer diagnosis is 66, so most of us have Medicare, most likely Part D, and often a supplemental or med advantage program. So our yearly copays are more likely in the $5,000 to $10,000 range. Substantial but still possible for us lucky ones. Some older patients are forced to choose between meds and food and rent.

A man with no insurance would have to be rather well-to-do to afford any of these treatments. In reality, men with no health insurance just don’t take these meds. Cancer patients are at the bottom of the food chain and pay what the traffic will bear. We know it is very expensive to develop these drugs. But the cost of many drugs has increased each year since they were approved by the FDA, even after research costs have been met.

There are Co-Pay Assistance programs to help those who can’t afford the high co-pay costs. My experience several years ago was not good—I applied, filled out forms, waited, there were delays, letters, personal information, more delays, etc. I finally gave up because I needed to get started on the prescription. If you have experiences with the copay assistance programs (good or bad) please share that with me and the blog readers.

If you were to buy these same drugs in Canada, India, Japan, or many other countries, the cost would be substantially less because other countries negotiate prices with the drug companies.

Factoid: The most common cause of bankruptcy in older Americans is massive medical bills they can’t pay. 

Final Note 
Growing old ain’t for sissies—especially if you have cancer.
 

axman