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Urologists are acutely aware of the cost of prostate cancer treatments and how they may impact patients' lives.
"The expense of care is always a concern. How effective is the medication? Is it worth the expense? Prostate cancer medications usually come into play after patients fail other treatments. Their effectiveness still needs definitive assessment.
Whether a 3-month life extension justifies the cost is an individual decision. The United States is unique compared to other countries because the bigger question of whether 3 months is worth the cost hasn't been broached by our health care system.
Julian Anthony, MD
Chula Vista, CA
"I am concerned about cost. We have wonderful medications that may really help patients, yet they're very expensive. How they're paid for will fall on the backs of insurers and patients.
These treatments are in the line of sight for cutting medical costs. As clinicians, we need to advocate for our patients. Oftentimes, decisions are made based purely on dollars.
Patient welfare, which should always come first, isn't necessarily of primary importance."
Stephen Lazarou, MD
" When patients don't have insurance, we try to utilize our local hospitals, which are able to work with patients to provide the best care possible. The issue is that the timing of care is often lengthened more than we would like in order to get patients into the system and start treatments.
Oncology is one area where smaller increments of time are perhaps appreciated more, since we're often dealing with end-of-life issues.The patient's perspective depends on the individual's outlook. Some, just grasping the extent of their disease, may look for additional time to accept their situation; others, battling cancer for years, may discount an additional few months.
It's easier not to introduce cost when talking to patients about their prognosis, but it must be discussed. Patients must know if there's a significant price for treatment. Whether they pay out of pocket or not, they certainly need to be aware of costs. Even if they have coverage, it can still impact their decisions, even if it simply impacts their compliance."
Brett Baker, MD