High Cost Of Risky Cancer Therapies Force Patients, Doctors To Make Tough Calls

Stat: Cancer Therapy Holds Great Promise — But At Great Cost
(Karen) Koehler was undergoing a promising — and terrifying — experimental therapy that her oncologists hoped could rid her body of cancer entirely. It’s called CAR-T therapy, and it works by engineering the patient’s own immune cells to attack cancer. ... The treatment induces such sudden and severe side effects that it can take a small army of top specialists to keep patients alive while their newly engineered immune systems attack their cancer cells. The result: CAR-T remains so risky, so complex, and so difficult to manage that experts warn it’ll be years before it’s available to most patients who would stand to benefit — even though two drug makers, startup Kite Pharma and pharmaceutical giant Novartis, are racing to get their versions of the therapy approved by the the Food and Drug Administration as early as next year. (Keshavan, 8/23)

Stat: Do 'Step Therapy' Policies Save Money, Or Hurt Patients?
As science makes once-unthinkable treatments available, patients are increasingly facing a harsh reality: Insurance companies are forcing them to try older, less expensive therapies for months before covering pricier ones. Insurers have long relied on a cautious approach to control costs and spare patients from expensive medications they might not need. But in more than a dozen interviews with doctors and patients, a picture has emerged of insurers growing more aggressive as they respond to financial pressures. (Tedeschi, 8/22)

The Fiscal Times: Why A Third Of American Health Care Costs Are Considered Unnecessary
The last time your doctor said you needed an MRI, a diabetes medication, a breast biopsy, or some other test or treatment, did he or she think about — or even know — how much it would cost? Or discuss whether your insurance would cover it? Most likely not, says Mitesh Patel. And this creates a problem. (Wharton, 8/23)