RT Book, Section
A1 A. Rios, Jorge
A1 Bhandari, Shruti
A2 Kloecker, Goetz
A2 Arnold, Susanne M.
A2 Fraig, Mostafa M.
A2 Perez, Cesar A.
SR Print(0)
ID 1176019137
T1 Economics of Lung Cancer
T2 Lung Cancer: Standards of Care
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260136203
LK hemonc.mhmedical.com/content.aspx?aid=1176019137
RD 2024/04/24
AB Kathy  was  diagnosed  with  advanced  adenocarcinoma  of  the  left  upper  lobe  metastatic  to  the  bones  in  January  2016.  Within  5  weeks  ofer  diagnosis,  she  had  low-dose  lung  computed  tomography  (CT),  a  second  chest  CT  scan  to  confirm  the  findings,  pulmonary  function  tests,  a  lung  needle  biopsy,  a  positron  emission  tomography  (PET)/CT  scan,  several  blood  tests,  and  next-generation  sequencing  searching  for  actionable  genetic  alterations  and  was  seen  by  a  medical  oncologist.  Kathy  was  deemed  not  a  candidate  for  targeted  therapy  or  immunotherapy  up  front  and  began  chemotherapy  in  March  2016.  Response  to  chemotherapy  was  evaluated  with  serial  CT  scans.  In  May,  Kathy  was  found  to  have  progression  of  her  disease  during  an  emergency  room  visit  and  started  second-line  immunotherapy  in  June  at  her  doctor’s  office.  The  immunotherapy  resulted  in  stable  disease  and  maintained  her  quality  of  life,  so  Kathy  continued  the  treatment  and  monitoring  through  the  end  of  the  year.Kathy  bought  an  individual  health  insurance  plan,  which  started  in  January  2016,  through  her  state’s  marketplace.  The  premium  for  her  plan  was  $537  per  month,  but  she  qualified  for  tax  credits,  which  helped  reduce  these  costs.  Kathy  ended  up  paying  $272  per  month  in  premiums.  Kathy’s  highest  costs  were  in  January  ($3,678)  and  February  ($3,716),  when  she  had  multiple  diagnostic  tests  and  paid  40%  percent  co-insurance  for  imaging  tests  and  scans,  in  addition  to  premiums.  She  met  her  maximum  out-of-pocket  limit  in  February;  after  that,  no  cost  sharing  was  required  as  long  as  she  paid  her  premiums  and  received  all  her  care  in  network.  At  the  end  of  her  plan  year,  Kathy  had  paid  a  total  of  $3,264  in  premiums  and  $6,850  in  cost  sharing  for  her  cancer  care.  The  total  health  care  costs  for  Kathy’s  lung  cancer  treatment  in  2016  were  $210,067.  Kathy’s  insurance  plan  paid  the  vast  majority  of  these  costs—$203,217.  (Adapted  from  an  American  Cancer  Society  Cancer  Action  Network  Report:  Singleterry  J.  The  Cost  of  Cancer:  Addressing  Patient  Costs.1)