Los Angeles Register: "Treating multiple myeloma offers lessons" by Bob Tufts

May 1, 2014 03:00 PM EDT

Bob Tufts: Treating multiple myeloma offers lessons

Originally published by the Los Angeles Register here.

Every year, more than 22,000 people in the United States are diagnosed with multiple myeloma, the second-most common type of blood cancer. In 2009, I became one of them.

Back then, less than half of patients with myeloma – which causes bone pain, fractures, and anemia – lived five years or more following their diagnoses. Thanks in large part to advanced new oral therapies, I'm still here five years later, and my cancer is even in remission.

Unfortunately, many insurers do not cover the most cutting-edge oral cancer treatments on the same terms as older intravenous or injectable ones. Consequently, many patients have to pay more for the most innovative therapies.

That must change. In addition to providing patients with new treatment options, oral therapies can reduce overall health spending – and actually stimulate the economy by allowing patients to live more productive lives.

Myeloma has hit Los Angeles County in particular. On an age-adjusted basis, 5.67 Angelenos per 100,000 were diagnosed with the disease annually between 2007 and 2011. That's higher than the statewide average.

American researchers and doctors have made great strides in the fight against multiple myeloma. Since 1974, the five-year survival rate for the disease has increased 70 percent. Between 2000 and 2009, the number of survivors in the United States increased 73 percent.

The story is similar for other forms of cancer. Five-year breast cancer survival rates have jumped 20 percent since 1974. For prostate cancer, they've increased 50 percent.

Innovative new treatments have a lot to do with these gains. Doctors now have more than 170 different anti-cancer treatments in their arsenal. Last year, the U.S. Food and Drug Administration approved 18 new cancer therapies, including one for multiple myeloma. In the last 15 years, the FDA has green-lit six new treatment options for multiple myeloma alone.

Not only are new therapies helping patients live longer – they’re changing the way people experience the disease.

The oral cancer therapy that I take to manage my myeloma for instance, has allowed me – and countless other patients – to receive treatment at home. As a result, we have been able to avoid costly inpatient visits, unnecessary travel expenses, and hospital stays. Our doctors have benefited, too – by picking up valuable time to spend with other patients.

By taking a pill to treat my disease, I am able to continue working – as are many others living with myeloma. This is especially important for hourly workers and those with limited sick leave.

Before the advent of innovative oral therapies, patients had to receive their treatments in a hospital or doctor’s office. Among blood cancer patients, oral treatments have helped reduce hospitalizations by over 40 percent.

The average cost of a night in the hospital exceeds $1,600. So treating patients at home can yield substantial savings for the patient and the healthcare system.

Some insurers have been blind to these benefits. They view oral cancer therapies as pharmaceutical rather than medical services – and so have subjected them to higher cost-sharing rules.

That approach can cost insurers in the long run. After accounting for spending on IVs, needles, supplies and labor, conventional intravenous cancer treatments cost $47 more per day than do oral therapies. That's equivalent to $17,000 more per year for a patient like me.

Policymakers should put an end to such waste – and simultaneously stand up for patients – by requiring insurers to cover oral cancer drugs on equal terms with intravenous chemotherapy. Mandating parity among cancer therapies isn't just good for patients – it's good for the healthcare system and the economy.

And they should act now. Cancer’s prevalence is only growing. The American Society of Clinical Oncology estimates that the number of new cancer cases could increase by 42 percent by 2025.

In recent years, medical innovation has begun transforming multiple myeloma into a manageable disease – and enabled countless people like me to lead longer, more productive lives.

It can do the same for other forms of cancer – as long as decision makers protect access to the latest effective treatments.

Bob Tufts is an adjunct professor of entrepreneurship at New York University and a former Major League Baseball pitcher for the Kansas City Royals and San Francisco Giants.

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