While cancer treatments are being developed at a rapid rate and offering hope to many patients, cancer has become the leading cost driver for funds. This combination poses a challenging problem (and opportunity) for fund leaders: How do we leverage the groundbreaking new innovations in cancer for our members while containing the increasing cost of treating (and at times curing) cancer?
STATS AND OBSERVATIONS:
- 40% of Americans will be diagnosed with cancer in their lifetime.[i]
- In 2022, cancer/oncology surpassed musculoskeletal conditions to become the #1 cost driver for health plans.[ii]
- Cancer deaths are down more than 33% since 1990 – much of that is due to new and emerging therapies.[iii] For example, new breakthrough therapies in lung cancer and advanced melanoma have dramatically improved outcomes in both diseases across the last 5 years.
- Breakthrough techniques are allowing some patients to avoid surgery all-together. A new study showed that immunotherapy alone cured 18 patients of early-stage rectal cancer with a specific mutation, a 100% success rate.[iv]
- The average cost of new cancer drugs is quickly approaching $300,000 a year[v], a 53% increase from 2017, and some treatments such as new cellular therapies can cost more than $500,000.[vi]
- New cancer detection technologies, such as GRAIL’s Galleri test, can detect 50+ types of cancer through a blood test, greatly improving our chances of catching cancers early.[vii]
IDEAS TO CONSIDER:
- With Bolton and our partners, do a deep dive into your cancer claims data (at no cost) to pinpoint potential opportunity areas. Gaining a deeper comprehension of cancer within the population can provide valuable insight into determining the most logical actions to include in your plan.
- Partnering with next-gen cancer screening blood tests (such as GRAIL) to catch numerous types of cancer at earlier stages when there is a greater chance for a cure (and lower cost to the plan).
- A focus on cancer-specific navigation programs that will lead every patient to fantastic centers for their specific diagnosis. New programs help members meet the experts that are well-equipped for their unique clinical situation and will help manage the cost of the plan.
If we can help, contact your Bolton representative, or email us at email@example.com.