Think Pink: Should The Cost Of Breast Cancer Care Be A Consideration?

Yesterday, I wrote an article about my grandmother’s experience with breast cancer. And it seems the part that struck a chord with most readers wasn’t as much about the emotional toll of the disease–it was the cost. Far and away, cancer survivors and family members who responded echoed the same sentiments that my grandmother expressed: that cancer care is really, really expensive. And yet, few doctors or patients even think to consider the price tag at the time of treatment. Should more doctors consider the cost of care before recommending courses of action?

It may seem insensitive to discuss cancer in dollars and cents, but the fact is that patients and their families do it all the time. In the United States last year, $16.5 billion was spend on breast cancer alone–and it’s predicted that that figure will continue to increase by 2-5% annually for the foreseeable future. And it wasn’t all by insurance companies and Medicaid–most of it was out-of-pocket, by cancer patients and their families.

Even women with insurance end up footing the bulk of the bill for their treatment. That’s because many health care companies simply can’t cover the amount that the care actually costs. With 1 in 3 women likely to have some form of cancer in her life, and 1 in 8 estimated to have breast cancer, that’s just too many people for insurance companies to fully cover. Many companies cap care coverage at around $10,000 –which is barely enough for a first round of tests and tumor removal. Add in the skyrocketing cost of diagnostic and detection tests, medication, high-tech treatments, and hospital stays, and the disease, which can be a years-long battle, becomes a giant financial burden. And that’s assuming that a woman is insured at all.

Even if a woman wanted to comparison shop, weighing the cost and effectiveness of various methods of treatment, it’s nearly impossible to get a straight answer as to the price of any of it. Most information is anecdotal, as providers and medical companies mostly recommend “talking to your doctor” or “asking your insurance.”

But after doing a little digging, it’s clear: the price of treating breast cancer is just plain prohibitive, whether a woman is insured or not. Consider the cost of chemotherapy. An  inexpensive, generic chemotherapy drug runs around $300 for an 8-month supply, which isn’t unaffordable.  But most doctors will recommend adding in one of the newer (read: non-generic) cancer-killing drugs, just as a precaution–which can add additional thousands of dollars to the overall cost.

According to one study in 2001, the mean cost for 1 year of radiation and “breast conservation treatment” (i.e., not a mastectomy) was around $18,000. For 5 years of treatment, it leapt to $45,000. And that was 10 years ago.

A more recent study, conducted this year by the Fred Hutchinson Cancer Care Center, found a more disturbing figure. With each year of survival, a cancer patient’s odds of bankruptcy increase 4 times within 5 years of diagnosis.

And yet, WomensHealth.gov explicitly states that the cost of treatment “should not be a consideration.” But is that realistic? When else in life would you not turn over the price tag and see how much something would be? When doctors have admitted to over-medicating and over-treating patients, is it possible that in our fervent fight against breast cancer, that pragmatism has truly gone out the window?

Should the cost of the care be a point of discussion when choosing a course of action? Should doctors be armed with the information about the end costs, or proceed regardless?  Every woman should be entitled to the best breast cancer care. But surviving the disease, just to be swallowed by medical bills, seems like a choice that no one should have to make.

Image:  Shevel Artur / Shutterstock