If you’re diagnosed with multiple myeloma or being tested for it, you want your full focus to be on slowing its spread and relieving your symptoms. Sometimes stress about treatment costs can make that hard to do.
The sooner you create a plan for managing myeloma’s costs, the sooner you can start treatment with a clearer head. Here’s a breakdown of the costs you could face:
Diagnosis
Based on your symptoms, your doctor may give you tests to find out if you have multiple myeloma. These can include:
- Blood tests
- Urine tests
- Removal of a bone marrow sample to send to a lab
- X-rays, MRIs, or CT scans for bone problems
Your health insurer works out special rates that, for example, might lower a medical lab’s billed rate for one multiple myeloma diagnostic test from $225 to about $25. Your deductible and copay apply before coverage starts. Medicare also covers diagnostic tests. But if you have no insurance, you’re responsible for the lab’s billed rate.
Doctor Visits
If results show you have multiple myeloma, your doctor (a specialist called an oncologist) may want to monitor your condition without treatment until your symptoms change. Or you may start a treatment plan to relieve pain, control complications, and slow the disease’s progress.
Once treatment begins, you should expect to visit your doctor and possibly other specialists every 3-5 weeks. After treatment, your team will follow you closely so they can identify signs that the disease is getting worse. You’ll have a follow-up in 3-6 months.
One study shows the average cost of an oncologist outpatient visit in the U.S. ranges from $198 to $391, depending on condition. Those visits are covered by private insurance and Medicare.
Medications
If your doctor decides you need medication, the price tag of cancer drugs can be staggering. Cancer drug therapies often involve a combination of two or three medications rather than just one. In one study, the total cost of a multi-medication therapy for people with multiple myeloma -- before insurance -- ranged from about $74,000 to as much as $256,000.
Standard treatment options include:
- Targeted drug therapies. Your doctor may turn to one or more of the many medications that focus on weaknesses in cancer cells. Among the drug categories used in targeted therapies are:
- Proteasome inhibitors like bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro)
- Histone deacetylase (HDAC) inhibitors such as panobinostat (Farydak) and vorinostat (Zolinza)
- Monoclonal antibodies like daratumumab (Darzalex), elotuzumab (Empliciti), and isatuximab (Sarclisa)
- Nuclear export inhibitors like eltanexor (KPT-8602) and selinexor(Xpovio)
- Immunotherapies. Here, medications interfere with the proteins that cancer cells create to hide from your immune system cells. Among the drugs your doctor may recommend are thalidomide (Thalomid), lenalidomide (Revlimid), and pomalidomide (Pomalyst).
- Chemotherapy. Just a few of the drugs that can kill fast-growing myeloma cells are bendamustine (Treanda), cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), etoposide (VP-16), liposomal doxorubicin (Doxil), and melphalan.
- Corticosteroid therapy. These medications regulate your immune system to help control inflammation and help ease nausea and vomiting from chemotherapy.
You can’t get most of these medications from a pharmacy, so online price shopping isn’t helpful.
Radiation and Other Procedures
If medications and chemotherapy aren’t completely effective, your doctor may use radiation. This treatment quickly kills or shrinks cancerous cells in areas where they’re weakening bones, such as your spine.
Another option is a stem cell transplant, in which a doctor takes blood-forming stem cells from your body and then injects them back into your body after you’ve had chemotherapy. Then they travel to your bones and start rebuilding marrow. Your doctor will typically consider this only if you’re younger than 65, or between 65-75 but very fit.
CAR T-cell therapy is similar to stem cell transplant. During this therapy, certain immune cells are taken from your blood. Then they’re altered in a lab and injected back into your body to help your immune system attack cancer cells.
Reliable statistics about radiation and stem cell transplant costs are hard to find, but online blogs and articles describe costs in the tens of thousands of dollars, before insurance applies. A CAR T-cell treatment can cost more than $373,000.
Tackling Costs of Your Cancer Treatment
The costs of multiple myeloma treatment can be huge even if you have quality health insurance. The American Cancer Society website offers several resources that can help:
- Assistance paying for prescription medications. A list of public and private programs that help pay for people’s medications or let them buy at discounted prices. Many pharmaceutical companies also offer medication assistance programs.
- Strategies for handling medical bills. Tips for negotiating with hospitals, medical practices, and insurance companies.
- Help with covering non-medical expenses. A list of programs that can help defray housing, transportation, caregiver, and other bills.
Another option to help bring down the costs of treating multiple myeloma is to enroll in a clinical trial. In a typical clinical trial, a health care provider or pharmaceutical company asks enrollees to try new drugs or drug combinations, new surgical procedures or devices, or new ways to use current treatments.
The National Cancer Institute’s “Treatment Clinical Trials for Multiple Myeloma” lists page after page of current clinical trials. But bear in mind: The trial sponsor may only pay for the drug or procedure being researched. Your health insurance (if you have it) would need to cover any other treatment. And insurers are increasingly skeptical about covering clinical trials; you should ask your plan beforehand how much it will pay.
