Cancer Drugs: A Cause for Concern
Federal health reform is changing the way millions of Americans purchase health insurance and receive healthcare services. Millions of uninsured Americans are now eligible to obtain coverage under the Patient Protection and Affordable Care Act, most of whom are newly eligible for Medicaid programs. Beyond the number of people that will have access to health insurance, looms the larger impact that the ACA will have on how providers and hospitals are reimbursed for and deliver care. Some areas of care will be more greatly impacted than others; notably among the greatest affected will be cancer care, which has historically been an unsustainably, costly area of care and is projected to be a core area of care as the Baby boomer population ages. The ACA, in effect, places great stress on an already costly area of care, where there has been a particularly high level of unending support for treatment advances and relatively little clinical benefit, for the most part. Long a consideration of cost cuts, the ACA might be a provoking factor which loosens the tracks of costly technological and pharmaceutical development giving rise to a new perspective of care focused on comfort and support. Although, abandonment of advancement altogether is not the likely outcome, what will most likely result from the ACA is a balancing tight rope of cost control and effective treatment. The practice of healthcare as we now know it will most likely be a memory of the past, given that the ACA and all its provisions are not upended. The most difficult part of the implementation process will be keeping the best interest of the patient in mind. While the administration’s and provider’s opinion might clash to make the best possible compromise, if a compromise is possible, the difficulty will be keeping the patient and his or her health at the centerfold of the conversation. Through an illustration of why cancer treatment is so high, the affect of the ACA and a proposed new model for care will be addressed all while keeping the patient in the center.
At our current state, cancer is the second most common cause of death in the United States, exceeded only by heart disease. Every 1 out of 4 deaths in the US is a result of cancer, and this year, about 580,350 US residents are expected to die from cancer which amounts to 1,600 people per day (American Cancer Society 2013). When looking at the greatest cause of deaths in Americans over the age of 85 years, however, cancer has recently surpassed heart disease as the number one killer. This is a major cause of concern as the baby boomer population ages, given the increase in the percentage of older Americans it is predicted that the percentage of Americans with cancer will also increase. In a report by Marsha Fountain, President of the Oncology Group articles, it is predicted that the number of people age 65 and older in the US will double between 2010 and 2050 and the cancer patient volume is expected to increase 45%, or more (2011). This increase in numbers will add strain to the hospital system, given the expected increase in hospitalization and overall surveillance of patients with cancer.
Coinciding with the high rate of cancer occurrences, cancer care contributes to a substantial and growing percentage of overall healthcare expenses. The National Institutes of Health estimate that the total cost of cancer care in the United States in 2008 was 201.5 billion. Of this total, $77.4 billion, or 38%, is allocated to direct medical costs including inpatient and outpatient care, drugs, and devices and $124 billion, or 62%, is attributed to indirect mortality costs including lost productivity due to premature deaths (American Cancer Society 2013). The impact of those costs is frequently catastrophic for families. A study led by Scott Ramsey of Seattle's Hutchinson Institute for Cancer Outcomes Research published in Health Affairs in May found that people with cancer are 2.65 times