Published on September 16, 2020
Chronic Myelogenous Leukemia Treatment Costs
Times are changing. Talking about sex, death and money are becoming less taboo, especially money. The financial burden of cancer care is a topic that everyone who has faced a cancer diagnosis knows all too well. Cancer is expensive, so don’t be shy about discussing the cost of treatment with your care team.
For chronic myelogenous leukemia (CML) patients, the increased use of tyrosine kinase inhibitors (TKIs) has caused patient treatment costs to skyrocket. The reason for their use? They work well and most patients will have a good quality life and a normal life expectancy — similar to that of the general population.
What Are Tyrosine Kinase Inhibitors?
TKIs are a special class of drugs that are the standard of care for CML. Also called chronic myeloid leukemia, CML is a cancer of the bone marrow. Its cells contain an abnormal protein called BCR-ABL which causes uncontrolled cell growth. TKIs target the BCR-ABL protein and block its function, causing the cancer cells to die.
Current TKI treatment options include:
- Imatinib (Gleevec)
- Dasatinib (Sprycel)
- Nilotinib (Tasigna)
- Bosutinib (Bosulif)
- Ponatinib (Iclusig)
While some patients need to stay on TKIs indefinitely to keep the cancer at bay, others may be able to stop treatment or lower their dose over time.1
Cost of Chronic Myelogenous Leukemia Treatment
A recent study in JCO Oncology Practice reported that the cost of CML care exceeded that for other blood cancers and reached upwards of $91,990 per year by 2015. Imatinib, in particular, cost $41,546 annually between 2000-2004 and then increased to $105,069 annually between 2015-2017.2
Cost estimates for cancer patients can be shocking, especially the out-of-pocket costs. In a wealthy area like Washington, DC, the average yearly salary is $76,000. Compare that to West Virginia where the average annual salary is $44,097 and you can see the stark differences in the ability to pay, especially since health insurance coverage in the United States varies from state to state.
Bridging the Financial Gap with Generic Drugs
Patients getting generic medicine will have less of a pain point at the pharmacy than those choosing brand name drugs. The average cost for imatinib for insured patients was $147 per month; that cost decreased to $85 per month when generic imatinib became available as an alternative to the brand name product.
Patients receiving Medicaid spent around $14 per month for the Gleevec brand of imatinib and half of that for the generic version. Also, the adoption of Medicaid expansion through the Affordable Care Act (ACA) has helped more patients pay for their cancer care.
Ask a Financial Navigator for Help
The good news is that navigating your cancer journey can be done with a team of helpers. While your healthcare team is addressing your medical needs, financial navigators and social workers can help you understand the costs associated with treatment. They can also offer solutions. For example, some pharmaceutical companies offer patient assistance programs to lessen the burden to your wallet, and a financial navigator will be able to help you identify available resources.
Financial expert Dan Sherman told Patient Power’s Andrew Schorr that approximately 42 percent of cancer patients experience a significant or catastrophic financial burden.
“Once the diagnosis has occurred and the treatment plan has been put together, then it would be very wise of the patient at that point to ask to speak to a financial advocate, financial navigator or social worker. There’s a different term for this position,” Dan said.
“Sometimes we can significantly decrease the cost burden for the patient if we take a very proactive approach on addressing the problem,” he added.
Dan’s team helps analyze the big financial picture for his clients to see whether he can help them optimize their insurance for better outcomes.
Cancer care comes with side effects and the money problems stem from what oncologists are now calling financial toxicity. Hopefully, the tools and information Patient Power provides can be a beacon of hope and help.
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1American Cancer Society. Targeted Therapies for Chronic Myeloid Leukemia.
2Wilkes JJ, Lyman GL, Doody Dr, et al. Health Care Cost Associated With Contemporary Chronic Myelogenous Leukemia Therapy Compared With That of Other Hematologic Malignancies. JCO Onc Practice. August 21, 2020.
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