Financial Toxicity in Cancer
They call it financial toxicity. Many multiple myeloma treatments cause unwelcome effects in myeloma patients. One of the most common side effects of myeloma treatments is peripheral neuropathy in which the patient develops pain or numbness typically in the hands or feet. Other treatments cause nausea, vomiting, and so on. The development of these conditions as a result of treatment is called toxicity in most research.
Financial toxicity is the unwelcome effect of multiple myeloma treatment on the financial wellbeing of patients.
Myeloma Health Insurance
In America, for reasons passing understanding, not everyone has health coverage. Even those that do can be bankrupted by paying a 20% co-insurance on treatments that can cost thousands of dollars or more, not to mention the various deductibles and out-of-pocket maximums.
Standard Revlimid prescriptions cost over $10,000 per month, although the drug company offers help with copays and other costs to avoid a stampede of cancer victims occupying legislatures around the country. For those with no insurance, they are at the mercy of the doctors and hospitals treating them.
Unlike many other cancers, myeloma treatment never really finishes. As they say, myeloma is not curable, but it is treatable. Those treatments are ongoing and very expensive, even for those lucky enough to be in maintenance mode.
The financial devastation of ongoing myeloma treatment can have numerous effects on cancer patients and their families. For many, the smart move is getting a divorce, putting all the assets in the spouse’s name and waiting to qualify for Medicaid. This is hardly ideal.
While myeloma doctors and oncologists have some control over the cost of treatment, they have no control over the cost of medications. What they do have is influence. Fully complete research with supporting data can be a powerful force in affecting change in the multiple myeloma treatment industry. Researchers are starting to do just that.
No matter how much the number drifts lower or higher anything remotely approaching 40 percent of cancer patients depleting their life savings is terrible for the patients, the providers, and the country.
The conclusion of this study is that a comprehensive financial resource alleviated financial toxicity in patients with cancer. Of course, the best help comes in the form of straight financial assistance. While free rides to doctor’s appointments and treatment sessions are a great relief, nothing compares with help paying $10,000 worth of copays and coinsurance.
Colorado Law and Cancer Treatment
There is a weird new law in Colorado about discounts on hospital care. When you go in for cancer care in Colorado, or any other type of care, at the hospital they will ask you to sign saying that you understand.
The law basically says that if you need help paying a hospital bill you can see if you qualify for discounted care by calling the hospital. That seems circular, but I guess lots of people don’t know that health care fees are basically set and charged like at a vendor booth in Tiajuana, so the bill you get might not be what you actually have to pay.
Regardless of what the guy signing you into the hospital says, the actual law states that if your gross household income is below 250% of the federal poverty level, then you might be able to get discounts and a payment plan based on your income. (In 2022, the federal poverty level for a family of four is $27,750, so 250% of that is $69,375.)
It also says that there is a maximum amount the hospital is allowed to bill you for regulated services and that you can get a payment plan which cannot be more than 4% of the patient’s gross monthly income. The payment plan cannot be longer than 36 months and once you make all of the 4% payments for 3 years, the bill is paid, regardless of what the fee was.
There is a lot of complexity regarding who can bill the patient for what, because sometimes a procedure involves a hospital, an oncologist, a lab doctor, and the lab. This is why the hospital is required by law to disclose to you what discounted care you are eligible for and what it should cost under this law.
This is a really great step in the right direction for health care in Colorado. The catch for multiple myeloma patients is that instead of one big hospital bill, you get a new bill for every infusion, injection, and so on and so on. Nevertheless, if your income is under $69,375 (for 2022) set up an appointment with the hospital billing department. Maybe the payments and limited costs can limit some of the financial toxicity that you experience.
About the Author
Brian Nelson is an expert on multiple myeloma via first-hand knowledge as a patient but is not a doctor. Brian was diagnosed with multiple myeloma in 2019. He has been living with it ever since. This article is for informational purposes only and is not medical advice. Check with your own doctors and insurance company about your specific situation for medical advice.