Chemo Costs Rising Dramatically

Chemotherapy costs are rising dramatically, and oncologists this year will get their first guidelines on how to talk with patients about the affordability of treatment choices."These are awkward discussions," says Dr. Allen Lichter of the American Society of Clinical Oncology, which is writing the guidelines. "At least we can bring this out in the open."It's a particular issue for patients whose cancer can't be cured but who seek the longest possible survival and the best quality of life.

The prices can be staggering. There are two equally effective options, for example, to battle metastatic colon cancer, the kind spreading through the body—but one costs $60,000 more than the other, says Dr. Leonard Saltz of Memorial Sloan-Kettering Cancer Center.

The difference? The cheaper one, irinotecan, causes hair loss that makes it impossible for people trying to keep a job to hide their cancer treatment, he explains. The pricier oxaliplatin can cause nerve damage in hands and feet that might make it a worse option for, say, a musician or computer worker."As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it's a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm," says Dr. Neal Meropol, who is leading the panel writing the American Society of Clinical Oncology's new guideline on how to weigh treatment costs.

The idea: Treat cost essentially as another side effect to weigh in choosing a therapy.At a meeting of the standard-setting National Comprehensive Cancer Network this month, Sloan-Kettering's Saltz and other doctors urged adding chemo prices to treatment guidelines.In renewing her prescription plan last year, Helen Geiger, 71, didn't notice that coverage had been changed for Thalomid to treat multiple myeloma, a blood cancer. It now cost a $1,051 monthly co-pay that she couldn't afford.

"You don't need this kind of stress when you're sick," says Geiger, who found a program that provided free medicine.