Colorectal Cancer: New Treatments, Improved Prognosis
New drugs show promise, but more research needs to be done.
A Dramatic Rise in Costs
The key problem with the new targeted therapies is their price.
"Avastin and Erbitux are outrageously expensive," says Anthony Back, MD, an oncologist at the Fred Hutchinson Cancer Research Center in Seattle.
The numbers show an explosion in the cost of treating colorectal cancer because of these drugs. One year's worth of treatment with the combination of Erbitux and Camptosar for metastatic colon cancer would add up to $161,000, according to an article published in the New England Journal of Medicine in 2004. Overall, the article noted that the costs for the first eight weeks of standard treatment for advanced colorectal cancer have risen 340 times over the past 10 years.
For people with insurance that covers medication, the actual costs may seem irrelevant. But even the co-payments for these drugs add up.
"Some people have 20% co-pays for these medications," says Back. "Over the course of therapy for metastatic cancer, that adds up to tens of thousands of dollars out of their own pockets." The high cost of drugs could force a person to make the impossible choice between extra months of life and financial ruin for his or her family.
"The benefits of these drugs are so dramatic that we can't deny people from getting them," says Damian Augustyn, MD, spokesperson for the American Gastroenterological Association. "But the costs will put an enormous strain on the health care system."
Saltz agrees. "It doesn't take an economist to see that these prices are unsustainable," he tells WebMD.
Although your insurance company may bear the brunt of these costs now, experts worry that even insured patients may be affected eventually. As the drugs become more widely used, their price tag could make insurance companies attempt to limit their use.
"With prices this high, I'm sure the insurance companies will start erecting barriers to patients trying to get these drugs," says Back. "These companies just can't afford it."
Saltz worries that it's already happening. He says some insurance companies are relying on "debunked" science -- namely, the EGF receptor test, which was thought to predict whether a person would be helped by Erbitux.