The cost of medication that is a part of the overall cost of care for patients with cancer is a growing concern. Many cancer drugs cost hundreds to thousands of dollars per dose.
Patients with metastatic castration-resistant prostate cancer (mCRPC) often choose between multiple first-line drugs as part of their treatment plan, but not much is known about the gross and out-of-pocket (OOP) prices of drugs for patients with employer-sponsored health insurance. Kaye et al sought to determine the gross and OOP prices of first-line drugs for the treatment of mCRPC and identify how payments for different drugs vary.
The study recruited 4298 patients with prostate cancer who had undergone therapy using 1 of 6 different drugs that were approved for first-line treatment of mCRPC between July 1, 2013, and June 30, 2019. The gross and OOP payments for each drug were compared by analyzing private payer claims data from patients using different first-line drugs during the 6 months after beginning treatment for mCRPC.
The gross payments were found to vary across drug types. During the 6 months after initial treatment prescription, the mean adjusted gross drug payments were highest for patients receiving sipuleucel-T ($115,525 USD) and lowest for patients using docetaxel ($12,804 USD). OOP payments were lower than gross drug payments. The mean 6-month OOP payments were highest for cabazitaxel ($1044 USD) and lowest for docetaxel ($296 USD), with a wide distribution of OOP payments within drug types.
Drugs for the treatment of mCRPC were found to be expensive, with large differences in payments depending on the drug type. OOP payments among patients with employer-sponsored health insurance were much lower than gross drug payments, and they vary both across and within first-line drug types, with some patients making very high OOP payments.
While lowering drug prices can minimize pharmaceutical spending for patients with mCRPC, decreasing patient financial burden requires an understanding of a patient’s individual benefit structure and treatment plan.
