NEW ORLEANS, LA USA (UroToday.com) - Cost of medications for castrate-resistant prostate cancer (CRPC) range from $24 000 to $93 000. The Canadian system is unique where the medications are provided free of charge rather than at a cost to the patients as is the case in the United States.
A group from Toronto conducted surveys to assess patients’ general understanding of castrate-resistant prostate cancer (CRPC), patient opinions on costs/benefit of currently marketed CRPC drugs, and to assess if/when patients would forego CRPC drug therapy in a medical system where most drugs are provided free of charge. Patients were also asked if they would deny any further treatment in exchange of one-time end-of-life premium of $50 000.
One hundred three patients completed the survey. CRPC was not understood by 79% of respondents. Most felt abiraterone was helpful and should be offered to all patients (71%). 65% felt enzalutamide should be offered for abiraterone failures despite any evidence of efficacy. Only 30% felt alpharedin was helpful at all.
Despite any evidence, a majority (58.2%) felt combination medications should be given even if the costs exceeded $250 000. However, out-of-pocket scenarios shifted opinions. If patients had to pay, only 29% were willing to exceed $40 000. More than 60% of patients would forego any therapy for a $50 000 one-time premium. Better educated/higher income patients were more likely to undervalue the benefit of CRPC drugs and take the end-of life premium.
The group concludes that a large gap exists between patient understanding of CRPC prognosis and drug value. Patients overvalue drugs when paid by third parties but see less value if they have to pay “out-of-pocket.” More realistic discussion between CRPC patients and their doctors about benefits of CRPC drugs are needed.
Presented by Tarik Benidir at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Toronto, ON Canada
Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com