That statement was the cue for a spokesperson at the Pharmaceutical Research and Manufacturers of America to wonder why patients pay a much higher share of total out-of-pocket costs for drugs than other medical services. In a press statement, deputy vice president Karl Uhlendorf said, "data from the Agency for Healthcare Research and Quality show that on average insured patients pay out of pocket about 4% of inpatient hospital costs, 16% of physician costs, and 27% of prescription drug costs."
He added that "given the high cost of these new oral medications, the implications for cancer patients of mandating full parity for oral and injectable chemotherapy medications is still unknown."
Like other disease-based interest groups, the American Cancer Society is keeping an eye on the essential benefits list being developed by the Institute of Medicine as part of the requirements of the Affordable Care Act. The hope is that the list will include some statements in support of evidence-based treatments for cancer that can be used to convince health plans to change their stance on oral cancer drugs.
Doctors aren't sitting around while their patient struggle to pay for these drugs. There are physician groups that lobby manufacturers to get free drugs for patients. And oncologists do have the fall back position of traditional chemotherapy if oral cancer drugs become too cost prohibitive. But physicians will tell you that the advantage of oral cancer medications, in addition to fewer side effects, is that they are more targeted to specific cancers and are often more effective.