Recession Causing Cancer Patients To Quit Life-Extending Drugs

In 2009 and 2010, as the economic collapse shuddered across the globe, oncologists in California noticed a troubling trend: Three patients who had had serious tumors under control for as long as eight years reappeared in the clinic with massive cancer regrowth which, in one case, required emergency surgery.

In retrospect, this downturn in fortunes should have been predictable: The economic recession had forced the patients to discontinue a life-extending medication.

"In all three cases, the patients developed new symptoms and came in after having missed an appointment or two without us knowing that they had stopped the drug," said Dr. Katie Kelley, co-author of a letter-to-the-editor in the Aug. 5 issue of the New England Journal of Medicine, which describes the cases. Kelley is also assistant clinical professor of medicine at the University of California, San Francisco (UCSF).

And there have been other such cases, both at UCSF and around the nation, either of patients stopping medications altogether or rationing in the hopes of making precious supplies last longer.

"Certainly we've seen an increase in affordability concerns," said Stephen Finan, senior policy director of the American Cancer Society Cancer Action Network in Washington, D.C. "Very definitely we've seen an upward trend in the last couple of years of people struggling with deductibles and cost sharing."

"There has been some evidence to suggest that it is happening on a wider scale," added Robert Freeman, professor of pharmaceutical sciences at Texas A&M Health Science Center's Irma Lerma Rangel College of Pharmacy. "This not only happens when the economy turns down, but if Medicare programs run into budgetary problems and become restrictive or if private co-payments go up."

All three patients described in the journal article had been taking Gleevec (imatinib) for gastrointestinal stromal tumors (GIST). Gleevec is considered by many to be a wonder drug, since it appears to be close to a cure for many people with a form of blood cancer known as chronic myelogenous leukemia (CML). The drug has also extended the average survival of GIST patients from just a few months to an average of five years, the UCSF team noted.

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