'Skin in the Game' and Importing Cancer Drugs

” ‘Skin in the game’ is a phrase that has gained popularity in the healthcare market. It implies that if patients have a personal financial stake in a decision, such as higher out-of-pocket expenses, they will be more prudent and act more responsibly.

“Skin in the game can work to some degree, note Hagop Kantarjian, MD, chair of the Department of Leukemia, the University of Texas MD Anderson Cancer Center, Houston, and colleagues in a viewpoint article published online July 2 in JAMA Oncology.

“However, for many cancer patients, it has become ‘life in the game,’ they add.”

An 'Utterly Broken' Drug Market: The High Cost of Surviving Cancer

“Lauren Baumann is one of the lucky ones.

“Though she has cancer, chronic myeloid leukemia, it is manageable, as long as she takes a daily pill called Gleevec. Gleevec is considered a wonder drug, turning Lauren’s leukemia from a death sentence to a disease she and thousands of others can live with. The problem is, even with health insurance and a full-time job, Lauren can’t afford the monthly co-pay for Gleevec. It can be as high as $2,000 a month — twice the average mortgage payment in the U.S.

” ‘I feel like you get punished,’ says Baumann. ‘I didn’t ask to get cancer; I didn’t ask to get sick. I was 26 and I was perfectly healthy.’ “

How Crowdfunding Helps Patients Deal with the High Cost of Cancer Care

“Cancer is not just a physically devastating diagnosis, it can be a very expensive one. Cancer patients are more than 2 and half times more likely to go bankrupt than people without cancer.

“And the Fred Hutchinson Cancer Research Center says young cancer patients have 2 to 5 times high bankruptcy rates than those 65 and older. Those numbers are why more and more patients and families facing cancer are turning to crowdfunding to help pay their bills. The internet is making it possible for these people to tap into the kindness of strangers and friends to help them in truly desperate times.

“At the start of May, 32-year-old Meghan Morgan was occupied with all the concerns of a single mom. Juggling the dog walking business she owns, Portland Pups, an unreliable truck and raising 13 month old Henry. Now at the beginning of June, she is overwhelmed. Henry is spending his third week in the hospital, diagnosed with a rare type of inoperable cancer called neuroblastoma.”

Money Woes Spawn Cancer Patient Treatment Shortcuts

“Even though health insurance usually pays for the lion’s share of cancer-related costs, it still is often not enough.

“A new study shows that many insured cancer patients must make changes to their lifestyle, and even to their adherence to treatment, to deal with the financial burden of the disease.

“The small survey involved 174 patients who were undergoing treatment for solid tumors. They were nearly all female (96%), and the majority had breast cancer (85%), but 4% had colorectal cancer and 11% had other types of solid tumors.

“All the participants had medical insurance, and all requested financial assistance through a national copay assistance program.

“However, despite their insurance status, many were struggling to pay for their care. The vast majority (89%) reported that they had to make at least one change in their lifestyle to cope with treatment-related costs.

“Of the patients who used lifestyle-altering strategies, 78% cut spending on leisure activities, 57% cut spending on basics such as food and clothing, 54% borrowed money to pay for medication, 50% dove into their savings, 18% sold possessions, and in 15% of cases, family members took on more work.”