Cancer Costs: Are You Asking The Right Questions?

Asking the right questions could help save you money on cancer treatment. In this guest blog post, Martine shares the top 5 questions that you should ask about treatment, insurance and more.

When faced with a cancer diagnosis, patients and their loved ones come to realize that their fight will likely involve substantial costs, bringing about even more uncertainty and anxiety. Looking for ways to pay the bills can become overwhelming, especially in a complex health care system. While insurance policies dictate patient liability, choosing an in-network or contracted oncologist will reduce costs. But all too often, patients assume they have no options because relevant information may not be communicated or they don't know which questions to ask. Here are five questions to ask your oncologist that could help you save money.

1. Is there an equivalent, less costly alternative to the prescribed treatment?

      Your oncologist has a lot of expertise, but it is often the case that, for early-stage cancer, there is more than one treatment option. My prior boss, a board-certified oncologist, once explained that she based her decision on three criteria: efficacy, impact on the patient's daily life and cost. Not all oncologists take those last two into account.

      Be honest with your doctor and explain your financial situation. Maybe you have to keep working to keep your insurance, or simply can't afford a more expensive treatment.

2. Is the pharmacy cheaper?

    Some growth factor treatments - such as Neupogen, Neulasta, Procrit, Aranesp and others - can be safely and easily self-administered at home. Call your insurance provider, as it may be more economical to obtain prescribed pre-filled syringes through a pharmacy rather than getting the shot at the office. A nurse can instruct you on how to do this safely and correctly.

3. What about samples?

      There may not be samples for chemo agents or growth factors, but many exist for anti-nausea or other supportive oral drugs. Emend, for example, can be priced at hundreds of dollars per month, but many doctors offices have samples of this and similar medications. In addition, some offices may even take back unused oral or self-injectable drugs from patients whose treatment has ended and who donate excess supplies for others in need.

4. What about financial assistance?

      Major drug manufacturers extend financial assistance for brand-name drugs, especially those related to chemo. Ask your doctor about programs and how to apply-offices can often help you sign up, or at least direct you to a website.

      You may also be eligible for drug donations if you are uninsured or underinsured, or if your insurance has denied an authorization. However, by law, patients with a government-issued insurance (Medicare, Medicaid, Tricare) are not eligible for direct donations or assistance from manufacturers.

      In addition, some charitable organizations offer financial assistance to cover the cost of chemo or related drugs. Based on income, specific diagnoses and clinical need, these grants can range from a few hundred to thousands of dollars and can be used to cover doctor or pharmacy bills.

5. Are home options cheaper?

      Some simpler treatments - including B12 injections, bone-building medications or iron infusions - are sometimes prescribed as part of specific chemotherapy regimens.

      Contact your insurance and compare the cost at home via a home health agency versus in the doctor's office. Though a B12 injection is quite inexpensive, the costs of the visit, parking and lost time from work can add up. If a nurse can come to your home - at your convenience and for less - it may be worth asking your oncologist if this is an option. Before going this route, however, get a list of contracted home health agencies from your insurance to make sure the order goes out to the right agency in a timely manner.

Some oncologists may resist some of your requests, while others may not welcome you questioning their decision and may interpret this as a criticism or lack of confidence in their ability as a physician. Reassure your doctor that your goal is to get the best, most appropriate treatment while making the process as cost-effective as possible. Remember that you have rights to the information and explanations necessary to make informed, educated choices. Being an active participant in your care can only help your oncologist help you.

Are there any questions we missed? Let us know in the comments below!