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Deborah Schrag, MD, MPH, lead author of the study.
The vast majority of advanced colon cancer patients in a clinical
trial were not concerned about the cost of prescription drugs for
managing chemotherapy side effects, such as infection, pain and nausea,
and few adopted strategies to reduce drug cost burdens after joining the
clinical trial, according to a study led by researchers at Dana-Farber
Cancer Institute in Boston. Although few patients reported substantial
worry about drug costs, still fewer reported discussing drug cost issues
with their physicians, suggesting there are opportunities for improving
how physicians integrate discussions about drug costs into clinical
The study's findings (abstract 9503) will be presented at the
American Society of Clinical Oncology's (ASCO) annual meeting in
Orlando, Fla. on Friday, May 29, 5:30 pm ET, Level 4, W414A.
"We were reassured to learn that few patients enrolled in the
clinical trial engaged in coping strategies to minimize the impact of
prescription drug costs, but we also recognize that these findings may
not generalize to patients treated outside the clinical trial context,"
said the study's lead author, Deborah Schrag, MD, MPH, of Dana-Farber.
Schrag added that given the current state of the economy, with a
growing number of people losing their jobs and possibly some or all of
their insurance coverage, "we could witness growing anxiety among cancer
patients about their ability to pay for medications that may help them
adhere to their therapy."
The researchers surveyed 409 patients with metastatic colorectal
cancer who were enrolled in a Cancer Leukemia Group B (CALGB) Phase III
clinical trial that compared outcomes of patients who received
combination chemotherapy in conjunction with bevacizumab and cetuximab
together or with cetuximab alone. The participants also received
prescriptions for "supportive" drugs, such as anti-nausea medications,
antibiotics and painkillers.
They explored whether financial concerns prompted the patients to
take money-saving steps that could negatively impact their care. They
found that 10 percent of the patients were very worried about paying for
their supportive medications, less than 15 percent adopted a
money-saving strategy — such as not filling a prescription, taking less
than the recommended dose — and 12 percent of the patients reported
speaking with their physicians about drug costs.
"The cost of cancer care today does force patients to make some hard
financial decisions," said Schrag. "As oncologists, we need to be
mindful that this issue may be a concern for some patients and that
communication about this topic both may help alleviate anxiety and
identify strategies to minimize the cost burden."
The study was funded in part by CALGB.
Dana-Farber Cancer Institute (www.dana-farber.org)
is a principal teaching affiliate of the Harvard Medical School and is
among the leading cancer research and care centers in the United States.
It is a founding member of the Dana-Farber/Harvard Cancer Center
(DF/HCC), designated a comprehensive cancer center by the National