New Blood Cancer Therapies Offer Great Value

Yet insurers continue to restrict access to these treatments

A 2015 cost-effectiveness study suggests that innovative treatments for blood cancers provide great value for patients and the health care system.

“This finding shouldn’t come as a surprise,” Bob Goldberg, co-founder and vice president of the Center for Medicine in the Public Interest, said. “This study confirms what other research has already found, which is that new treatment options are helping patients live longer and healthier lives and doing so at a reasonable cost.”

In the analysis, Tufts Medical Center health economist Peter Neumann and colleagues reviewed 29 studies on the cost of new blood cancer therapies. They found that 73 percent of the therapies analyzed cost less than $50,000 for each additional year of healthy life that they provide. Health economists usually consider therapies cost-effective if this number is below $100,000.

New Blood Cancer Therapies Offer Great Value

Even though most new blood cancer therapies have been shown to provide good value, many insurers are still refusing to cover the treatments or are forcing patients to pay up to half of the costs.

As a result, patients are struggling to pay for their prescriptions—and they’re letting their physicians know about it.

“Doctors don’t have patients coming in to complain about the cost of their surgery or hospitalization—which are on par with the price of novel therapies—because those services are usually covered,” said Goldberg.

New treatment options are helping patients live longer and healthier lives and doing so at a reasonable cost.

The difference stems from how insurance plans have been historically structured to separate medical and pharmacy benefits, which has led to patients’ paying more for prescription medications than medical services that have the same price tag.

“We need to look at the big picture and make decisions that are based on facts, not anecdotes,” Goldberg said. “Let’s look at the role that medicines have played in history and the negative impact of trying to ration therapies.”

The concept of health insurance is to protect patients from catastrophic costs, but today it’s failing to do so for many with blood cancers. We need to provide equality for cancer treatments and limit how much insurers can force patients to pay.