Compliance and cost: Bitter pills to swallow in the age of oral ch...( (ORLANDO) Though the growing shif...),Health

(ORLANDO) Though the growing shift toward oral chemotherapy agents offers cancer patients greater freedom and independence during their treatment, physicians say use of the new medications also poses more chances for patients to skip doses, miss prescription refills, and take their drugs in a dangerous way. An increasing number of cancer patients who receive chemotherapy now do so at home, with the click of a pill bottle each day rather than the drip of an IV medicine that must be delivered in a doctor's office or hospital.

"People assume that if you have cancer, you're going to take your medication, but for a whole host of reasons, that may not happen," says Angela DeMichele, MD, MSCE, an associate professor of Medicine and Epidemiology at the University of Pennsylvania's Abramson Cancer Center, who will present a session called "Compliance and Cost: Bitter Pills to Swallow in the Era of Oral Cancer Treatment" on Sunday, May 31 at the American Society of Clinical Oncology (ASCO) annual meeting. "We need to recognize the reality of non-adherence and better understand how to help our patients take their medications in the most effective way.

Studies have shown that when patients don't adhere to their medication regimens, costs for their health care balloon due to more physician visits, more hospital visits, and longer stays once they're admitted. In addition, non-adherence during clinical trials may take a toll on the patient population at large, since the efficacy and toxicity data generated from studies may be flawed and unreliable when patients don't take their medications as directed.

A chief reason for non-adherence is money: Many of these medications are extremely expensive, and insurance coverage for these expensive oral chemo agents is spotty, leaving many patients to pay a substantial proportion of the cost of their drugs out of pocket. Many older patients find that the Medicare Part D prescription coverage leaves them r
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