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Solutions needed to lower 'unsustainable cost' of care for hematologic malignancies
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Treatment costs for hematologic malignancies exceed those of other cancer types, and they place lasting burdens on patients and the health care system, according to results of a study commissioned by Leukemia & Lymphoma Society.
“We frequently hear from [patients with blood cancer] about the rising costs associated with lifesaving treatment,” Gwen L. Nichols, MD, chief medical officer of Leukemia & Lymphoma Society, said in a press release. “As this new study shows, each payer in the health care system has a role to play in lowering these costs so patients can access their care.”
HemOnc Today spoke with Nichols about what prompted this research, what the data show, and what can be done to reduce costs associated with blood cancer treatment.
Question: What prompted this research?
Answer: In May 2017, the society launched the Cost of Cancer Care Initiative by putting forward more than 24 potential policy solutions and other recommendations aimed at reducing the cost of care and improving transparency across the oncology ecosystem. We are working to protect and promote the interests of patients with hematologic malignancies by helping to address the unsustainable cost of care, and this new study informs this work by providing critical data about the cost of hematologic malignancy care in commercial insurance plans.
Q: How was the research conducted?
A: Leukemia and Lymphoma Society commissioned this study by the actuarial firm Milliman to assess the cost drivers within the U.S. health care system associated with treating hematologic malignancies among patients enrolled in commercial insurance plans. Using real-world claims data of people with commercial insurance, Milliman performed a longitudinal study of 2,332 patients with an initial diagnosis of a hematologic malignancy in 2014. This study examined the many differences in treatments and spending patterns for newly diagnosed patients for five types of hematologic malignancies — acute leukemia, chronic leukemia, lymphoma, myeloma and bone marrow disorders.
Q: What did the findings show?
A: This study produced four key findings. First, hematologic malignancy care is very expensive to the health care system. Second, services that drive spending by health plans differ from those that drive patient out-of-pocket costs. Third, very high spending occurs immediately following diagnosis. Finally, patient out-of-pocket costs are high, but they differ depending on insurance plan type and when in the year a patient receives the diagnosis.
Q: Which hematologic malignancies are associated with the highest costs?
A: Different types of blood cancer have different cost implications for the health care system and for patients. Acute leukemia and myeloma are the costliest to the health care system, but they have very different cost profiles. Patients with acute leukemia have extraordinarily high costs, and those costs are highest around the time of diagnosis. In contrast, patients with myeloma accumulate similar costs to the system when we account for their substantial, ongoing costs even 3 years after diagnosis.
Q: What should be done to address the problem?
A: The society is working to harness the findings of this study to pursue solutions, including policies that will drive down these costs without sacrificing patient care. We have been focused on helping stakeholders set up incentives to reward providers for efficient, high-quality care, stimulate competition in the prescription drug market and promote value-based contracting for new drug therapies. These are just starting points for this important work.
Q: Is there anything else that you would like to mention?
A: Armed with these new data, Leukemia & Lymphoma Society looks forward to continuing to work with stakeholders across the oncology ecosystem on solutions that put patients at the forefront in addressing the unsustainable cost of cancer care. – by Jennifer Southall
Reference:
Dieguez G, et al. The cost of burden of blood cancer care. Milliman Research Report. Available at: www.milliman.com/uploadedFiles/insight/2018/cost-burden-blood-cancer-care.pdf. Accessed on Jan. 19, 2019.
For more information:
Gwen Nichols, MD, can be reached at Leukemia & Lymphoma Society, 3 International Drive, Suite 200, Rye Brook, NY 10573.
Disclosure: Leukemia & Lymphoma Society received support for the study from Amgen, Genentech and Pfizer. Nichols reports no relevant financial disclosures.