New ACS CAN Report Examines Expected Patient Costs for Common Cancer Diagnoses

Key Points

  • Total patient costs, including premiums, deductibles, co-pays and co-insurance, range from nearly $6,000 a year on an employer-sponsored plan to a little more than $10,000 on an exchange plan.
  • A lower-premium insurance plan may not actually save patients with cancer money in the long run.
  • Limits on out-of-pocket costs significantly lowered patients’ expenses in two of the three insurance scenarios.

On April 11, the American Cancer Society Cancer Action Network (ACS CAN) released its first report examining the costs of treating cancer, specifically the out-of-pocket portion patients face. The report, released at the organization’s annual national policy forum, found U.S. cancer patients paid nearly $4 billion in out-of-pocket costs in 2014 and the disease cost the country $87.8 billion in cancer-related health-care spending.

The report examines costs for three of the most common cancers (breast, lung, and colorectal) under three types of insurance (employer-sponsored, Medicare, and an individual exchange plan). The total patient costs, including premiums, deductibles, co-pays and co-insurance, range from nearly $6,000 a year on an employer-sponsored plan to a little more than $10,000 on an exchange plan. Most of these costs accrue right as a person is diagnosed, leaving patients with significant payments due in a short amount of time.

Moreover, these out-of-pocket costs can be compounded if a patient needs to seek out-of-network care or needs a treatment that is not covered by their insurance plan.

“For cancer patients and their families, the costs of cancer care are truly staggering,” said Chris Hansen, ACS CAN President. “This report makes clear the importance of insurance coverage, but also offers insight into the extent even insured patients struggle to afford treatment. If we are going to continue reducing cancer-related death and suffering, we must ensure that these patients and survivors have access to quality health insurance that meets their needs and is affordable to buy and to use,” said Hansen.

Additional Findings

Key report findings include:

  • A lower-premium insurance plan may not actually save patients with cancer money in the long run. Such plans often have high-cost sharing and patients with cancer are high utilizers of care.
  • Even with insurance, patients with cancer often face unpredictable or unmanageable costs including high co-insurance, high deductibles, having to seek out-of-network care, and needing a treatment that is not covered by their plan.
  • Limits on out-of-pocket costs significantly lowered patients’ expenses in two of the three insurance scenarios. Without these limits, patients’ costs would have sky-rocketed.

The report comes as Congress and the administration continue to consider possible changes to the nation’s health-care system. In a worst case scenario, those changes could alter important insurance market reforms, like allowing insurers to charge people more based on their health status and history, enabling plans to deny people coverage based on a pre-existing condition, and significantly altering the health services insurance plans must cover, all of which are critical to providing patients with affordable access to quality insurance.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


Advertisement

Advertisement



;
Advertisement

By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.