May 29, 2009 The vast majority of advanced colon cancer patients in a clinical trial were not concerned about the cost of prescription drugs for managing chemotherapy side effects, such as infection, pain and nausea and few adopted strategies to reduce drug cost burdens after joining the clinical trial, according to a study led by researchers at Dana-Farber Cancer Institute in Boston.
Although few patients reported substantial worry about drug costs, still fewer reported discussing drug cost issues with their physicians, suggesting there are opportunities for improving how physicians integrate discussions about drug costs into clinical practice.
The study's findings are being presented at the American Society of Clinical Oncology's annual meeting in Orlando, Fla. on Friday, May 29.
"We were reassured to learn that few patients enrolled in the clinical trial engaged in coping strategies to minimize the impact of prescription drug costs, but we also recognize that these findings may not generalize to patients treated outside the clinical trial context," said the study's lead author, Deborah Schrag, MD, MPH, of Dana-Farber.
Schrag added that given the current state of the economy, with a growing number of people losing their jobs and possibly some or all of their insurance coverage, "we could witness growing anxiety among cancer patients about their ability to pay for medications that may help them adhere to their therapy."
The researchers surveyed 409 patients with metastatic colorectal cancer who were enrolled in a Cancer Leukemia Group B (CALGB) Phase III clinical trial that compared outcomes of patients who received combination chemotherapy in conjunction with bevacizumab and cetuximab together or with cetuximab alone. The participants also received prescriptions for "supportive" drugs, such as anti-nausea medications, antibiotics and painkillers.
They explored whether financial concerns prompted the patients to take money-saving steps that could negatively impact their care. They found that 10 percent of the patients were very worried about paying for their supportive medications, less than 15 percent adopted a money-saving strategy -- such as not filling a prescription, taking less than the recommended dose -- and 12 percent of the patients reported speaking with their physicians about drug costs.
"The cost of cancer care today does force patients to make some hard financial decisions," said Schrag. "As oncologists, we need to be mindful that this issue may be a concern for some patients and that communication about this topic both may help alleviate anxiety and identify strategies to minimize the cost burden."
The study was funded in part by CALGB.
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