ASCO Rx for high drug costs: doctors and patients need to talk.

A special task force of the American Society of Clinical Oncology (ASCO) recently issued a Guidance Statement on the Cost of Care , which advises oncologists to speak with their patients about the cost of treatment. While urging ASCO to also address underlying economic factors that drive costs, the guidance focused on issues at the practice level. " The task force tried to address the rising costs of cancer care and how it affects the practicing of quality medicine and the well-being of the patient, " said chair Medical School in Boston. The statement highlighted a recognized problem: Doctors and patients have difficulty broaching fi nancial topics in the context of an offi ce visit. But it did not offer specifi c suggestions on how to effect changes necessary for both sides to communicate. In fact, several large, entrenched roadblocks need to be overcome before this kind of communication can take place, according to oncologists and patient advocates. Few dispute the importance of such discussions or the effect that costs can have on patient care. " Without a conversation about cost, there is no way for doctors to know how many patients are being forced to make decisions about treatment while weighing other demands such as supporting their families [and] children to be educated , " Schnipper said.gist and end-of-life specialist at the Mayo Clinic in Rochester, Minn., agreed: " The reality of it is, a prescription you don't take because you can't afford to has a zero response rate. If an aromatase inhibitor costs a patient $300 out of pocket versus $70 for tamoxifen, it is important for an oncologist to know if this expense will affect the patient's compliance, " he said. Moynihan is also concerned about prescribing a high-cost treatment without fully describing its risks and benefi ts to a patient near the end of life. " If someone is going to get a very expensive therapy, their doctor needs to explain that it may only change their outcome by 6 weeks, they may have to