Drug Price Should be Part of Treatment Decision Making, Leading Cancer Doctor Says

“I would be a pretty bad doctor if I didn’t talk about the cost of drugs with my patients,” Dr. Sekeres says.

The high drug costs contribute to an increased risk of cost-related nonadherence, cancer recurrence, and mortality. The United States is at a particular disadvantage when it comes to drug costs because the Food and Drug Administration can approve drugs without considering cost.

Dr. Sekeres says there are drugs that get approved by the FDA and are marketed heavily that may not actually extend a person’s life any more than a cheaper alternative. Avoiding marketing gimmicks has unfortunately become a part of the process when deciding on cancer treatment.

If an expensive treatment is needed, there are some programs in place to help pay the bills. People undergoing treatment can apply for financial assistance from pharmaceutical companies or from the government. Many clinics have social workers on hand to assist with filling out forms and applying for aid.

Ongoing Efforts to Lower Drug Costs

State and federal policymakers have taken steps in recent years to ease the financial burden of high‑cost medications, particularly for patients who rely on “specialty drugs” used to treat complex conditions such as cancer, multiple sclerosis, and hepatitis C. A handful of states have passed laws aimed at lowering out‑of‑pocket costs for these therapies, which often carry significant price tags for both patients and insurers.

Since 2007, most states and Washington, DC, have also enacted oral oncology parity laws. These laws generally require insurers to offer comparable cost‑sharing for oral cancer drugs and those administered by clinicians. Research shows that parity laws have provided modest financial relief for many patients, but they have not been enough on their own to fully protect people from high out‑of‑pocket expenses.

The true cost of developing a new drug remains difficult to pin down, with estimates ranging widely—from about $160 million to as high as $2.6 billion. In response to rising drug prices, many states have adopted pricing transparency laws, which in turn have spurred additional policy efforts to curb costs.

At the federal level, the Inflation Reduction Act (IRA) of 2022 introduced some of the most significant prescription drug reforms in Medicare’s history. The law authorizes the Department of Health and Human Services to negotiate prices for select high‑cost drugs—beginning with Medicare Part D medications in 2026 and expanding to Part B drugs in 2028. It also includes rebates for price hikes that outpace inflation, expanded subsidies for prescription drugs, and a redesigned Medicare drug benefit that caps annual out‑of‑pocket spending.

Among the first 15 Medicare Part D drugs selected for negotiation are several major cancer therapies, including the prostate cancer drug Xtandi, the breast cancer drug Ibrance, and the multiple myeloma treatment Pomalyst.

WATCH: Coping With Financial Toxicity

Budgeting for Treatment

• Calculate deductibles and estimated out-of-pocket costs for medical treatment.
• Total the amount you have available in your emergency reserve, health savings account, and flex spending account.
• Tighten your budget by reducing or eliminating non-essential expenses. Look at the money spent on shopping, food delivery, entertainment, subscription services, etc.
• Review your payroll deductions and, where it makes sense, reduce or eliminate optional ones. Some pre-tax deductions will have minimal impact on your take-home pay. Before making any changes, ask your HR contact to calculate the impact.

Sources for Immediate Financial Assistance

Cancer care often comes with steep financial strain, and many patients feel that pressure early in their treatment journey.

“Cancer treatment is incredibly expensive,” says Laurie Ostacher, a medical social worker at Sutter Bay Medical Foundation in California.

Even with insurance, people frequently face high out‑of‑pocket costs that can shape their decisions about care.

Health insurance plans differ widely in how much they cover and when. Some offer lower deductibles, meaning the plan begins paying sooner. Others require patients to meet a much higher deductible before coverage kicks in — a barrier that can lead some people to delay appointments or avoid treatment altogether because the upfront costs feel overwhelming. Coverage gaps can also extend beyond medical bills, leaving patients without adequate support for time away from work or other needs that arise during treatment.

“Most people are working when they’re diagnosed, and finances are a significant issue for them,” Ostacher explains.

For those who need or want to take time off, Ostacher often discusses available disability programs. State disability programs can help replace income during unpaid medical leave, though the level of support varies depending on where someone lives.

Federal disability programs also exist, offering financial assistance based on individual circumstances and income.

A medical social worker can help patients understand these options, estimate potential benefits, and navigate the application process.

Beyond government programs, many nonprofit and advocacy organizations provide additional financial support. The Lazarex Cancer Foundation, for example, reimburses patients for travel and lodging related to clinical trial participation. Groups like the American Cancer Society and Cancer Support Community also help patients secure housing, transportation, and other practical support tied to their care.

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