Kidney cancer patients beaten by medicine bill

by YankeeJim | June 13, 2011 at 03:47 am

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It is very hard to keep hope when you have been diagnosed with cancer. It happened to me.

My blood pressure was sky high. I was diagnosed with hypertension. I took blood pressure medicine, though it was very hard to control. After a year of tests and office visits, I made a second trip to the urologist who said that I needed a CT scan.

After the scan, he called me in to discuss the results and told me I might want to bring my wife. We met him late in the day and he delivered the bad news. “You have a very large growth on you kidney and in my experience it is likely to be cancerous.”

When these things happen, your heart sinks. I was feeling very sick with combined symptoms of kidney and heart issues. I was burning up as my chemistry was out of control.

I am cutting this part of the story short, though suffice it to say that I had surgery to remove a kidney. The recovery was pretty fast and the cancer was stopped and eliminated without spreading. It took months to get my system back to normal, getting the right combination of medicines.

The cardiovascular system came in line with 1) expensive medication, 2) diet, and 3) exercise. The kidney performance was picked up by the remaining kidney. I am cancer free.

Another calamity happened as I lost my hearing. That could have happened, in part, due to medications.

So, now I am one of those people that I used to read about: 1) retired, 2) disabled, and 3) facing the high cost of prescription drugs and ongoing medical attention.

If government could just relieve some of the pressure by minimizing the cost of prescription drugs, that would be quite a help. In my opinion, it is un-American to force people without means to make life or death decisions about taking medicine that is needed to save their lives.

That is the Republican plan, get sick; die quick. That is not acceptable.

“High copays blamed as 1 in 6 Medicare recipients don’t fill prescriptions for new cancer drugs By Associated Press, Updated: Monday, June 13, 5:08 AM WASHINGTON — Facing a life-and-death struggle with kidney cancer, Rita Moore took her prescription for a new kind of chemotherapy pill to her local drugstore.
She was stunned when the pharmacist told her the cost for a month’s supply would be $2,400, well beyond her income.

Medicare drug plans that cover seniors like Moore are allowed to charge steep copayments for the latest cancer medications, whose cost can run to tens of thousands of dollars a year. About 1 in 6 beneficiaries aren’t filling their prescriptions, according to recent research that has put numbers on a worrisome trend.
Officials at Medicare say they’re not sure what happens to those patients — whether they get less expensive older drugs that sometimes work as well, or they just give up. Traditionally, chemotherapy has been administered intravenously at a clinic or doctor’s office. Pills, a relatively new option, are thought to represent the future of cancer care.

Moore, 65, was operated on in February for an advanced form of kidney cancer. She said both her cancer and kidney specialists agreed that a drug called Sutent probably offered the only chance to keep the disease in check. It’s a capsule taken at home.

But she was unprepared for what happened when she went to fill her prescription.

“I cried,” said Moore, who lives in a small town in central California. “What can you do when the only thing out there that can maybe give you some quality of life is unaffordable? I was devastated. I didn’t know what to do.”

Private insurance companies that deliver the Medicare prescription benefit say the problem is that drug makers charge too much for the medications, some of which were developed from taxpayer-funded research. The pharmaceutical industry faults insurers, saying copayments on drugs are higher than cost-sharing for other medical services, such as hospital care.

Others blame the design of the Medicare prescription benefit itself, because it allows insurers to put expensive drugs on a so-called “specialty tier” with copayments equivalent to 25 percent or more of the cost of the medication.

Drugs for multiple sclerosis, rheumatoid arthritis and hepatitis C also wind up on specialty tiers, along with the new anti-cancer pills. Medicare supplemental insurance — Medigap — doesn’t cover those copayments.

“This is a benefit design issue,” said Dan Mendelson, president of Avalere Health, a research firm that collaborated in a recent medical journal study on the consequences of high copayments for the new cancer drugs.

Cost-sharing should only be used to deter wasteful treatment, he explained. “It is hard to make the argument that someone who has been prescribed an oral cancer medication doesn’t need the drug,” added Mendelson.

The study last month in the Journal of Oncology Practice found that nearly 16 percent of Medicare beneficiaries did not fill an initial prescription for pills to treat cancer, a significantly higher proportion than the 9 percent of people with private insurance who did not follow through.”