Higher Out-of-Pocket Costs Correlate With Worse Cancer Care

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Across cancers, higher costs tied to higher rates of oral prescription abandonment, delayed initiation.
Across cancers, higher costs tied to higher rates of oral prescription abandonment, delayed initiation.

(HealthDay News) -- Across cancers, higher out-of-pocket (OOP) costs are associated with higher rates of oral prescription abandonment and delayed initiation, according to a study published online in the Journal of Clinical Oncology.

Jalpa A. Doshi, PhD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective claims-based study using 2014 to 2015 data for individuals with a new, adjudicated prescription for any of 38 oral anticancer agents. For the index oral anticancer agent, the rates of claim reversal, delayed initiation, and abandonment were examined.

The researchers found that the risk-adjusted rates of claim reversal ranged from 13 to 67% among the final sample (38,111 individuals), with the rates increasing with higher OOP costs. The overall abandonment rate was 18%, with highest risk-adjusted rates in greater OOP cost categories (10% for ≤$10 group versus 13.5% for $50.01 to $100 group, 31.7% for $100.01 to $500 group, 41% for $500.01 to $2,000 group, and 49.4% for >$2,000 group; P < 0.001 compared with ≤$10 group). After accounting for alternate oral, injectable, or infusible anticancer agent use, the rates remained similar. Higher OOP cost categories more frequently had delayed initiation (3% in the ≤$10 group versus 18% in the >$2,000 group; P < 0.001).

"Higher OOP costs were associated with higher rates of oral prescription abandonment and delayed initiation across cancers," the authors write. "Fiscally sustainable strategies are needed to improve patient access to cancer medications."

Several authors disclosed financial ties to the pharmaceutical industry; the study was funded by Pfizer.

Reference

Doshi JA, Li P, Huo H, Pettit AR, and Armstrong L. Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents. J Clin Oncol. doi: 10.1200/JCO.2017.74.5091

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