Cost of Cancer Care

With the cost of cancer care rising at an alarming rate, more of the cost burden is shifting to patients, many of whom are responding by delaying or even foregoing their cancer treatment.

For example, studies show cancer patients in Medicare Part D are five times more likely to abandon their treatment when they face high cost-sharing. Policymakers must act boldly, as high year-over-year increases in cancer treatment and care costs will continue to strain the health care system and put cancer care out of reach for more patients.

LLS launched our Cost of Cancer Care initiative in May 2017, developing aggressive but feasible cost-cutting ideas that would not sacrifice quality care.

LLS believes all stakeholders - drug makers, pharmacy benefit managers and insurers, health care providers, and other patient organizations - must take responsibility and do their part for any meaningful progress to be made in bending the cost curve.

To advance this vision, LLS has since:

  • Engaged in substantive discussions with House and Senate health care leaders to make the case for our proposals to cut costs for patients and taxpayers.
  • Met several times with the Health and Human Services (HHS) Secretary Alex Azar and his top advisors, Further, LLS was invited to feature the story of a volunteer patient advocate at a high-profile public meeting at HHS regarding the struggle of Medicare patients to afford care.
  • Engaged LLS’s policy advocates across the U.S., convening meetings with federal and state policymakers.
  • Shaped and supported several regulatory changes, in order to demonstrate the patient community support for reforms that save money while maintaining access to care.

Several of LLS’s policy recommendations have been adopted, including:

  • Reduction of certain hospital overpayments that promoted hospital consolidation.
  • Accelerating lower-cost generic alternatives to branded drugs into the market.
  • Leveling the playing field for lower-cost biosimilar versions of costly biologic drugs, and Initiating a test of a major Medicare Part D reform that lowers costs for patients and taxpayers.

In March 2019 LLS called on Congress to enact 31 specific healthcare system cost-saving policies, described here.

  • Reduce hospital payments for all services that can be delivered in less-costly physician clinics.
  • Crack down on tactics used by drug companies to extend their monopoly pricing.
  • Cut regulations that inhibit the ability of insurers to hold drug companies and providers accountable for patient outcomes and other measures of value.
  • Provide the tools for patient/clinician discussions around the value of every treatment options.
  • Increase transparency by holding drug companies accountable for high list prices and price increases, and cap the out-of-pocket liability for patients for their therapies.

LLS enables cancer patients to raise their voice by connecting these volunteer patient advocates with their policymakers at strategic moments. LLS empowers advocates to tell their story and hold their lawmakers accountable for policy changes that promote affordable access to care.

Learn More


POLICY RECOMMENDATIONS

Letter to House leaders, June 2019, Medicare Part D reform on out-of-pocket costs

Letter to Senate Leaders, March 2019, 31 policy recommendations to reduce cancer cost

A Patient Perspective

Patients Fighting Back Against High Costs
These five stories highlight the impact blood cancer patients have when they become advocates for change within their communities.

Navigating the Costs of Cancer Care
This LLS infographic shows the constant, often overwhelming financial burden patients face during their cancer treatment journey.

LLS-SUPPORTED RESEARCH

Specialty Drug Pricing and Out-of-Pocket Spending on Orally Administered Anticancer Drugs in Medicare Part D, 2010 to 2019.
Published in JAMA, the Journal of the American Medical Association LLS-supported study explores out-of-pocket costs for blood cancer patients in Medicare Part D

The cost burden of blood cancer care. Published by Milliman, Inc
LLS-funded study explores treatment costs for patients with commercial insurance coverage.

The cost burden of blood cancer care in Medicare. Published by Milliman, Inc.
LLS-funded study explores treatment costs for patients with Medicare insurance coverage.