Why Is Cancer Treatment So Expensive?
Cancer can take a serious physical and emotional toll. On top of that, people with cancer often face a major financial burden. This includes paying for potentially life-saving treatments.
In the United States, medical costs for cancer care are especially high. In 2018, people with cancer paid more than $5.6 billion dollars out of pocket for cancer treatment. People with breast cancer pay more out of pocket than those with other cancers. And research shows that those living with metastatic breast cancer face even higher costs.1,2
The high cost of breast cancer treatment
In 2020, breast cancer had the highest treatment costs of all cancers. Total medical costs for breast cancer were $29.8 billion. That breaks down to:3
- $26.2 billion for medical services
- $3.5 billion for prescription drugs
Even with insurance, breast cancer is one of the most expensive cancers to treat. Compared to people with other types of cancer, people with breast cancer spend more on medical supplies, medical services, and oral drugs.3,4
There are a few reasons for this. People receiving treatment for breast cancer use more medical services. Many of them will need ongoing treatment, which adds up over time.4
What is more, people who have breast cancer that has metastasized face even more healthcare costs. Research shows there is a significant cost burden linked with metastatic breast cancer treatment. In fact, people with metastatic breast cancer pay, on average, $7,564 more per month during initial treatment than people without cancer.2
Because metastatic breast cancer does not have a cure, many people with this diagnosis need treatment for longer periods of time. Many also need end-of-life care, which is expensive. These factors drive up treatment costs.2,5
Reasons for variations in cancer costs
While some consistent factors can lead to higher cancer care costs, these costs can vary a lot between people. There are several reasons for this.1,4
Differences in insurance coverage
Health insurance can help people pay for cancer treatment and care. But there are many variations in insurance coverage and types of insurance plans. How much you pay out of pocket can depend on the type of insurance coverage you have. People without health insurance face a heavy burden of paying for all treatment cost.1
People of color, people with less education, and people with lower income are less likely to have access to and get the best healthcare. Without the ability to access care, they are less likely to get screening or a diagnosis while their cancer is in an early stage. They also are less likely to be insured, which means they have to overcome even more barriers to accessing treatment.1,4
These differences are called health disparities, and they add to the high cost of paying for cancer care.1
Differences in treatment plans
Cancer treatment is a major cost of cancer care. Everyone has a unique treatment plan, which can include several therapies. It can include multiple rounds of surgery, chemotherapy, or radiation. The plan can include expensive drugs and indirect care like counseling or physical therapy. Certain types and amount of treatments within a plan can drive up cost.1
Why is metastatic breast cancer treatment so expensive?
There are a few factors that contribute to the cost of MBC treatment. Two main reasons are the resources necessary for treatment and the cost of developing new treatments.
Cancer treatment is resource-intense
Cancer treatment is complex. Someone with cancer may use several therapies, such as radiation, chemotherapy, or surgery. Along with their oncologist (cancer specialist), they also may see a team of doctors for support and care. This team may include highly trained specialists. Paying these highly skilled providers drives costs up.1,6
Surgery and radiation are considered resource-intense treatments. Highly trained doctors and technicians perform surgery and radiation sessions using new technology and specialized equipment. Paying for the medical staff and the technology also drives costs up.1,6
Drug prices are determined by manufacturers
In the United States, drug prices are set by the market and the drug companies. Drug companies are always developing new and novel cancer treatments. That takes money. So, drug companies set and justify high prices for cancer drugs to help recover all their costs from the research, development, and production of a drug.7,8
Research and development for effective new treatments is expensive for drug companies. It requires safety testing, trials, and production costs. The high prices also help offset costs invested in failed therapies.7,8
It does take significant investment to develop an effective treatment. But the World Health Organization has also pointed out that drug companies set prices based on their profit goals.7
Change could be on the way
Until recently, federal law prevented the government from negotiating drug prices. This was a big barrier to reducing cost.8
But now, Medicare (a government-run health insurance program) can negotiate drug prices. The Inflation Reduction Act made this possible. Negotiations should help lower costs of some of the most expensive drugs.9
By negotiating for lower prices of some drugs, government officials say that more people will have access to life-saving drugs at a fair price. These officials hope negotiation will help spark competition and development of new therapies. These steps could help drive prices down for all.9
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