Dr Hatem Soliman Addresses the Economic Burden of Metastatic Breast Cancer Treatment

The financial toxicity of newer metastatic breast cancer (MBC) treatments is a significant concern and requires stakeholders to work together to find the best value- and evidence-based treatments for patients, said Hatem Soliman, MD, medical director, Clinical Trials Office, Moffitt Cancer Center.

With treatment costs for patients with metastatic breast cancer (MBC) rising across the board, Hatem Soliman, MD, medical director of the Clinical Trials Office, Moffitt Cancer Center, explains how this economic burden affects patients and how stakeholders can help reduce low-value care and unnecessary costs.


How does the economic burden of MBC affect patient outcomes, and are there solutions to overcoming this roadblock to treatment for some patients?

One of the areas that's also garnering a lot more interest—particularly with the advent of newer treatments that have been a blessing for our patients and allowing them to live longer with their disease—is that we do acknowledge that the financial toxicity of these treatments is a significant concern. Particularly because as patients live longer with the disease and rely on these medications in order to be able to thrive with their cancer as a chronic condition, these costs are not inconsequential. Some of these can be a significant burden on patients and their families and quite a strain on their resources and finances over time as they try to seek therapy for their disease. And it can be quite life altering.

One of the other issues that you may run into is that patients may lose the ability to remain gainfully employed. Through that decreased productivity and challenges that come with our health care system—particularly the employer-based health care system—if a patient loses their ability to be gainfully employed, that can have devastating effects on their ability to be able to afford treatments and require us to employ numerous strategies in order to try to prevent their treatment from being disrupted. This involves close partnership with our social workers and our financial teams in order to be able to counsel patients effectively on their options and seeking creative ways through foundations and other means to try to provide valuable support for those patients in order to defray some of those costs and reduce some of those burdens.

I think from a systems-based and also payer-based approach, there's a lot of evidence showing that when costs are shifted more to the patient and their share of the financial burden increases, that can have a detrimental impact on their ability to stay compliant with treatment. I think it requires all the stakeholders across the board—be them government payers, private payers, PBMs [pharmacy benefit managers], physician practices, national guidelines, and expert groups—to try to come together in order to figure out what is the best way that we can maximize the value of proposed treatments based on evidence and data so that patients can get the treatment that they need that we know can have a substantial impact on improving their productivity and their ability to participate in life with their patients, while also reducing unnecessary costs that are considered low value or that would jeopardize access to care for patients that are being covered by payers.

There isn't one solution that will fit all scenarios. I think we have to come together as a health care system and involve patient advocacy as well in order to balance out the various needs of the stakeholders across the system and make sure that it continues to function and that everybody is served well in the current system, but that we can still preserve access and quality of care for patients in the years to come.

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