Can You Handle The Cost Of Beating Multiple Myeloma?

A multiple myeloma diagnosis brings more than just medical challenges, it hits the wallet too. From costly medications and doctor visits to hospital stays, the expenses can add up fast. But understanding how treatment progresses and where the costs come from can help you plan better. Here’s a breakdown of what you need to know about the financial side of treating multiple myeloma.

What Does Treatment for Multiple Myeloma Involve?

Treatment for multiple myeloma isn’t one-size-fits-all. Doctors design plans based on how the disease is progressing and how each patient responds to different treatments. So, what works for one person may not work for another, meaning costs can vary a lot from one patient to the next.

Why Every Patient’s Plan Looks Different

Doctors adjust treatment plans as they go, depending on how the disease behaves and how well treatments are working. Some patients might need more intense treatments up front, while others may have more mild options. These personalized plans give the best chance for success but make predicting costs a lot harder.

The Price of Early-Stage Combination Therapy

Most patients begin treatment with a combination of drugs like Bortezomib (Velcade), Lenalidomide (Revlimid), and Dexamethasone. 

These drugs are essential in the early stages, but they’re also expensive. The patient will likely undergo several cycles of treatment, which adds up quickly during the first phase.

This early phase can be tough financially, as these medications are given in cycles, sometimes over several months.

Maintenance Therapy

After the patient goes into remission, the goal shifts to keeping the disease from returning. This phase, called maintenance therapy, is usually less costly than the initial treatments. 

But, it still comes with ongoing expenses. Drugs like Lenalidomide are commonly used here, and although maintenance therapy is spaced out more, the costs still pile up.

Where Does the Money Go?

Managing multiple myeloma involves much more than just taking pills. Patients need regular checkups, specialized care, and sometimes hospital stays. All of this can drive up costs high.

Specialized Treatment Centers

Around 60% of patients opt for specialized care centers, where experts provide cutting-edge treatment. These centers offer the best chance for positive outcomes but come at a higher price than general healthcare providers.

Outpatient Visits

Patients usually have to visit their doctor about 12 times a year for checkups, blood tests, and ongoing monitoring. These visits are crucial for tracking disease progression and managing side effects, but the costs can quickly add up, especially when you’re seeing specialists.

Hospital Stays

Sometimes, patients need to be admitted to the hospital. For example, the average stay lasts around 16.26 days for those going through the stem cell transplantation, but some patients require longer stays or multiple admissions. This can result in substantial costs, sometimes as much as $10,000 to $50,000 per hospitalization.

Home Care Services

For many patients, managing symptoms and side effects at home becomes necessary. They use home care services, like nursing visits or palliative care, which provide good relief but also add extra costs. These services typically cost between $100 and $300 per visit.

The Cost of Emergency Situations

Unplanned health problems can also lead to extra costs. Patients may face emergencies like infections or complications from treatment, and these can add unexpected expenses.

Emergency Room Visits

On average, multiple myeloma patients end up in the emergency room about 0.6 times a year. Each visit can cost around $449, so while it might seem small, those visits can add up, especially when complications arise.

Hospitalizations for Emergencies

From 2011 to 2019, the number of hospitalizations rose from 20,584 to 25,373, usually due to complications or the disease itself. Hospitalizations for emergencies contribute a big chunk to the overall cost, especially when care is extended.

The Bigger Picture on Total Expenses

The total costs for treating multiple myeloma can be eye-popping. Between high-priced medications, frequent doctor visits, hospital stays, and emergency care, the expenses can quickly surpass what many expect.

Annual Costs You Need to Be Ready For

The average yearly healthcare costs for multiple myeloma treatment can exceed $415,320. This includes everything from outpatient visits and medications to hospital stays. Even with insurance, many patients still face hefty out-of-pocket expenses.

End-of-Life Care

In the final stage of treatment, expenses rise dramatically. Patients may need more intensive care, like extended hospital stays or advanced palliative treatments. The cost during this stage can average around another $15,870.

Rising Prices and What’s Behind Them

The costs of treating multiple myeloma have been steadily increasing, and there’s no sign of this slowing down. Here’s why:

• Annual Cost Increases: Spending on MM treatments has soared. For instance, Medicare spending on MM drugs grew from $2 billion in 2013 to $10.2 billion in 2021. This increase results from new, more expensive therapies entering the market.

• Follow-Up Care: After the initial treatments, patients need ongoing monitoring and maintenance therapy. For example, lenalidomide costs around $168,000 annually, or $14,000 per month and it is almost same price of lenalidomide in USA also.

Medication Costs: Why Are They So High?

The medications used to treat multiple myeloma are among the most expensive cancer drugs available. These high costs, combined with the need for long-term treatment, can add up quickly.

Here’s a quick look at the costs for the most commonly used drugs:

• Pomalidomide (Pomalyst): Approximately $24,160 for a 28-day supply of 4 mg capsules.

• Lenalidomide (Revlimid): Around $22,300 for a 28-day supply of 5 mg capsules.

• Bortezomib (Velcade): Generic name is Bortezomib costs approximately $212 per 2.5 mg injection.

• Carfilzomib (Kyprolis): Approximately $30,000 to $40,000 per month.

• Ixazomib (Ninlaro): Approximately $10,680 for a supply of 3 mg capsules.

• Daratumumab (Darzalex): Approximately $165,230 per year.

These drugs are essential to treatment, but their high price puts a lot of pressure on patients. Also, please note that these prices are ballparks and can vary based on factors such as location, pharmacy, and insurance coverage. There are also other emerging medicines like cilta-cel (Ciltacabtagene Autoleucel) which will have much higher fluctuation in prices. However, choosing the generic options for Pomalidomide and lenalidomide can be very beneficial for patients to lower multiple myeloma cost.

What Makes These Drugs So Expensive?

There’s more to the high costs of multiple myeloma medications than meets the eye. Here are some key reasons:

Complex Manufacturing

Some of these drugs, like Daratumumab (Darzalex) and Pomalidomide (Pomalyst), are complicated to manufacture. Some even use living cells in the process, which drives up Daratumumab and Pomalidomide costs. Those manufacturing costs are passed on to patients.

High Research Costs

Creating these drugs takes years of research and clinical trials. The costs of development are steep, running into billions, and that gets reflected in the price of the drugs once they hit the market.

Limited Patient Pool

Multiple myeloma is a relatively rare disease, meaning fewer patients need the drugs. The chance of getting multiple myeloma during a lifetime is less than 1%. For men, it’s about 1 in 103, and for women, it’s about 1 in 131. As a result, drug manufacturers can’t spread the development costs across a large patient base, which keeps prices high.

Patent Protection

Many of the drugs used for multiple myeloma are still under patent protection, preventing cheaper generic versions from being available. Without competition, prices remain sky-high.

Practical Tips to Save Money

Although the financial side of multiple myeloma treatment can feel overwhelming, there are ways to manage the costs.

• Financial Assistance: Many drug companies offer patient assistance programs, and organizations like the Leukemia & Lymphoma Society can help cover medication costs or transportation expenses.

• Generic Alternatives: If available, generic versions of some drugs can help lower costs. Ask your doctor if these options might be right for you.

• Medical Tourism: In some cases, patients look into medical tourism. Countries like India and Turkey offer high-quality care at a fraction of the price you might pay in the U.S., especially for treatments like stem cell transplants.

• Use Your Insurance: Make sure you’re maximizing your insurance coverage. A financial counselor can help appeal denied claims and potentially lower out-of-pocket costs.

Taking Charge of Your Treatment Costs

The cost of treating multiple myeloma is large, but it’s not impossible to manage. By learning about financial assistance programs, exploring insurance options, and being proactive about treatment planning, you can ease the financial strain and focus on what really matters: getting the best care possible.