Monday, March 2, 2015

A cheap little pill

I have often blogged about the high prices of medications because I think some of them are just astronomical and are partly priced based on what their manufacturers think is something along the line of the value to patients. If a pill costs $100,000 and will make you get a break from your ailment, would you be willing to pay it (with help from your insurance company)?

But to see for example of how price impacts patient's compliance with the doctor's advice, look at this study. Basically it found that household net worth had a large impact on women continuing their post breast cancer hormonal therapy - aromatase inhibitors.

Its a relatively cheap little pill. I was on tamoxifen and now on letrozole (femara) which costs me a few dollars (less than $5) for a 90 day supply now that a generic is available. It has shown to greatly reduce recurrence rates for breast cancer. Previous studies suggested a five year course after treatment ends but now new studies show that ten years or longer are even better. Thus, I will be on it for a few more years, at least.

Some parts of me are amazed that a cheap little pill could be helping prevent a cancer recurrence. Other parts of me think of it as just a cheap little pill and maybe I could stop it so I had one less pill to take each day. My oncologist doesn't want me to be off it for more than a couple days at any time. If there is a gap in my supply because I forgot a refill, she will be happy to do what she can to make sure I have a supply.

So back to the study. Apparently 10% of women stop taking their aromatase inhibitors each year and 24% never start them or stop them overall. Even though they can reduce your risk of recurrence by 50%. So there is  a potentially big impact for those who take them. The study showed that lower net worth households (this is all assets - house, stocks, cars, etc - less debt (mortgage, loans, credit cards) have a higher rate of discontinuing their hormonal therapy. It was not influenced by income or race as usually reviewed.

If patients have enough issues in complying with their doctor's advice for an inexpensive little pill that has high impact, what about the affordability of these higher priced medications?


MichiganSurvivor said...

Caroline -- one thing to consider:
AIs (and tamoxifen) often have side effects, particularly ones affecting joints and other body parts.
It may be that women who are more well-to-do have the types of jobs that do not cause considerable by pain by stressing body parts. I know I sit down at work.
In addition: suppose you have kids who take meds, and you have $20 per month for medication in your budget
Get who gets their medication

Caroline said...

Exactly. So if finances are tight, one of the first things to go is expenses for the parents instead of for the child. And then they expect us to be able to pay for those hugely expensive new drugs.