HighCost of Medication Regimens for Lung Cancer
HighCost of Medication Regimens for Lung Cancer
Thearticle I choose to summarize focuses on the treatment costs of lungcancer in addition to patient responsibility, stages of the diseaseand treatment modality (Cipriano et,al.,2011). The primary aim of this article was to provide a detailedreview of the approximated costs incurred for the treatment of lungcancer. The article also evaluates the shared costs with a focus onMedicare beneficiaries. Estimation of the monthly andpatient-liability costs was done using records from SEER-Medicaredata from 1991 to 2003. Summation of patient liability costs,Medicare reimbursements and co-insurance reimbursements were used toestimate the costs. Chemo-radiotherapy represented the highestmonthly liability expenses incurred by the patients. Treatment costsfor lung cancer are significantly high, and this is aided by theincreasing number of Medicare beneficiaries.
Thelungs are located on the right and left side of the chest. In thefrontal section, they extend from the clavicle downwards to the 6thrib bone. Backwards, they extend to the area around the 10thrib. Towards the twelfth rib, the lungs are covered with protectivelinings known as pleura. The heart is located between the lungs whichare divided into different parts referred to as the lobes. The rightand left lungs differ depending on the number of lobes present. Theright lung has three lobes, on the upper part, middle and lowersection while the left lung has two lobes placed on the upper andlower sections. Intake of oxygen into the red blood cells is one ofthe primary functions of the lungs which then transport oxygen todifferent parts of the body. The lungs also aid removal of carbondioxide. During inhalation, the pharynx and larynx facilitate thepassage of air into the windpipe which is divided into tubes known asbronchi. The right lung receives air supply from the right mainbronchus while the left lung receives its supply from the left mainbronchus. The bronchi divide into smaller bronchi which furthersubdivide into bronchioles which are connected to the alveoli whichprovide a surface for oxygen entry and carbon dioxide expulsion.
Thetype and stage of the cancer will significantly influence thetreatment options. Staging of lung cancer is done to determinewhether the cancer is localized or generalized. Lung cancer cangrouped into three major forms
Non-small cell lung cancer (NSCLC) this is prevalent in approximately eighty five percent of lung cancer patients. Stages of NSCLC include stage one, stage two, stage three and stage four.
Small cell lung cancer (SCLC) is prevalent in about 15 percent of lung cancer patients and they have a tendency to grow more quickly the NSCLC. Stages of SCLC includes the limited stage and extensive stage.
Lung carcinoid tumor it is less common represents for approximately 5 percent of lung cancer patients. They have a tendency to grow slowly and hardly spread to other parts.
Treatmentcosts for lung cancer are significantly high with the older being themost affected population as compared to young adults (45 years andbelow). Various factors have to be considered when selecting thetreatment plan for a lung cancer patient. These factors include typeand stage of cancer, patients overall health and their treatmentpreferences such as targeted drug therapy, radiation therapy,chemotherapy and surgery. Surgery involves removal of the canceroustissues through either wedge resection, segmental resection,lobectomy and pneumonectomy. After surgery, remaining malignant cellsare usually killed using chemotherapy. Radiation therapy may beemployed as an initial treatment for lung cancers that are difficultto remove during through surgery. Targeted drug therapy is a newapproach to treating cancer that targets certain abnormalities incancer cells. The available drugs used in targeted therapies includeBevacizumab (Avastin), Nivolumab (Opdivo), Afatinib (Gilotrif),Ceritinib (Zykadia), Erlotinib (Tarceva), Crizotinib (Xalkori) andRamucirumab (Cyramza). Cancerous cells have to be tested for geneticmutations because certain targeted therapies only target cells whichhave undergone specific transformations (Rosamond,2013). Typically, treatment for lung cancer is covered by health insurancealthough some plans may exclude certain individual drugs or treatmentoptions.
Treatmentoptions for lung cancer may involve one or a combination of differentoptions with different cost variances. Surgery may cost $15000 ormore, cost range for chemotherapy is from $10,000 to $200,000 or evenmore, the cost of radiation therapy is between $10,000 to $50,000 ormore and finally $4,000 or more per month for medication. An exampleis the cost of ranibizumab (Lucentis) which is about $1,600 per dosewhile the cost of Erlotinib (Tarceva) is about $3,500 per dose. Theoverall estimated cost of treating lung cancer is about $46,000. Thiscost includes the period from diagnosis to a timeline of two years.Some of the factors contributing to this cost are hospitalizationfees and outpatient visiting costs. Lung cancer patients are usuallyhospitalized for a minimum period of seven days with an approximatedtotal cost of $15,600. Additional costs emanate from initialtreatment failure which may require additional treatment options.However, the Hill-Burton program which is sponsored by the federalgovernment offers provisions for free/low-cost services to qualifyinglow-income patients (Siddiquiand Rajkumar, 2012).
Thereis urgent need to reduce the cost of cancer treatment mainly throughremoval of research bureaucracy, involvement of Medicare in pricenegotiations, allowing for drug importations for personal use anderadicating pay-for-delay strategies (Kantarjianet,al.,2014).
Cipriano,L. E., Romanus, D., Earle, C. C., Neville, B. A., Halpern, E. F.,Gazelle, G. S., & McMahon, P. M. (2011). Lung cancer treatmentcosts, including patient responsibility, by disease stage andtreatment modality, 1992 to 2003. Valuein Health,14(1),41-52.
Kantarjian,H., Steensma, D., Sanjuan, J. R., Elshaug, A., & Light, D.(2014). High cancer drug prices in the United States: reasons andproposed solutions. Journalof Oncology Practice,10(4),e208-e211.
Siddiqui,M., & Rajkumar, S. V. (2012, January). The high cost of cancerdrugs and what we can do about it. In MayoClinic Proceedings(Vol. 87, No. 10, pp. 935-943). Elsevier.
Rosamond,T. (2013, January). The high cost of cancer drugs and what we can doabout it. In MayoClinic Proceedings(Vol. 88, No. 3, p. 306). Elsevier.