While precision medicine has been able to match cancer patients to targeted therapies, Kaiser Health News reports that some patients forgo or consider forgoing those treatments due to their high cost.
Kristen Kilmer tells it that after she was diagnosed with incurable breast cancer, she learned her tumor harbored a PALB2 rearrangement and studies has suggested that she might respond to AstraZeneca's Lynparza. But since her health insurer considers the treatment experimental, Kaiser Health News says it'll only pay for part of the $17,000 a month cost, leaving Kilmer with the choice of eschewing the treatment or falling deep in debt.
A study in the Journal of the American Medical Association over the summer found that even when patients are matched to a targeted therapy, they don't always get the treatment. "When you drill down, I think the problem we found isn't that the mutations aren't there, it's that patients aren't getting the drug," Carolyn Presley, the study's first author and a thoracic oncologist at Ohio State University, told GenomeWeb at the time. She also tells Kaiser Health News that, without insurance coverage, affording the therapy is difficult.
The South Dakota State Employee Health Plan, which runs Kilmer's plan, tells Kaiser Health News that it bases coverage decisions on published randomized studies of drugs' safety and efficacy.