The high cost of treating blood cancer may contribute to delayed initiation of active treatment in newly-diagnosed Medicare beneficiaries.
A new study released by The Leukemia & Lymphoma Society (LLS) finds that nearly 60% of patients with blood cancer covered by traditional Medicare do not begin active treatment within 3 months of their diagnosis.
Patients diagnosed with blood cancer typically incur high financial burden in the first year of diagnosis and beyond, which may be a driving factor in delaying or forgoing treatment. With advancing therapies leading to improved outcomes for the disease, many patients are surviving and carrying the financial burden for years after their initial diagnosis.
A previous study examined the cost burden for patients with blood cancer covered by commercial insurance plans. These findings indicated that the average costs of treating blood cancer are higher than for other cancer types.
The study, which was commissioned from Milliman, identifies factors driving costs to the health care system and the impact on patients. The researchers used average national data for Medicare Advantage Prescription Drug (MAPD) and Fee for Service (FFS) beneficiaries, identifying 35,877 FFS and 1898 MAPD patients with newly diagnosed blood cancer in 2015.
High out-of-pocket (OOP) costs are a common obstacle for many patients. According to the study, some Medicare patients with lymphoma who receive anti-cancer therapy via infusion experienced OOP costs of more than $19,000 in their first year after diagnosis. For patients with acute leukemia, many enrolled in traditional Medicare who received infused anti-cancer therapy saw OOP costs of more than $16,000 in that same period.
For patients who require ongoing treatment, costs may extend 2 or 3 years beyond their diagnosis. The study also showed that after 2 years, patients newly diagnosed with multiple myeloma in traditional Medicare experienced cumulative OOP costs averaging approximately $24,000.
For actively treated patients, average allowed spending incurred the 2 years following diagnosis was $200,409 per FFS patient and $165,967 per MAPD patient, the study found. These costs appeared to be higher in the first year after diagnosis and were largely driven by anticancer drug therapy.
Acute leukemia and multiple myeloma demonstrated the highest cost of all blood cancers and these patients incur the most OOP spending, according to the study.
Overall, the analysis found that 45% of the newly-diagnosed MAPD population and 41% of the FFS population received active treatment for their blood cancer within 90 days of diagnosis. Treatment varied widely by cancer type. The lowest rates of active treatment were among patients with bone marrow disorder, whereas the highest rates were seen among patients with multiple myeloma.
According to the study authors, federal and legislative regulatory changes have been proposed to address these high drug costs, which could help reduce the burden for both payers and patients.
“In the interim, the cost burden to both Medicare payers and patients will likely increase as more efficacious novel therapies are introduced and survival of blood cancer patients improves, and the high out-of-pocket burden for Medicare enrollees diagnosed with blood cancer will likely continue,” the authors wrote in the report.
Fitch K, Ferro C, Pittinger S. The cost burden of blood cancer care in Medicare: a longitudinal analysis of Medicare Advantage and Fee for Service patients diagnosed with blood cancer. Milliman Research Report. 2019. https://www.lls.org/sites/default/files/National/USA/Pdf/Milliman-Cost-Of-Blood-Cancer-In-Medicare-20191016.pdf.
Nearly 60% of Blood Cancer Patient Covered By Medicare Delay or Forgo Treatment [news release]. Leukemia & Lymphoma Society’s website. https://www.lls.org/lls-us-hq/news/nearly-60-of-blood-cancer-patients-covered-by-medicare-delay-or-forgo-treatment-one-factor-could-be-high-cost-of-cancer-care?news=News%20Releases&newsid=12355. Accessed October 22, 2019.