ijustwantadoughnut58 karma2020-10-19 15:31:31 UTC
I'm an oncology pharmacist. Just about everyday I lament the state of healthcare in the USA. Fortunately, my clinic has a huge financial assistance department that can arrange for free drug, radiation, copay assistance, etc, but its not enough. One patient who was in the country illegally was diagnosed with an aggressive breast cancer. We were able to get her free drug and treatment, but it delayed her care by a week. Another patient has no insurance and is delaying her radiation appointment to identify a treatment plan because she doesn't want more charity care. Radiation will probably cost $200k. Shes receiving free drug that costs $36k cash per month. That cost isn't even unusual for an oral chemo regimen. Another patient on a $38k/mo drug ended up paying $1000 copay each month because he didn't qualify for assistance. He was very well off, and the cost didn't seem to bother him, but I don't think anyone should have to pay that for a life saving medication. Another patient wants to join a clinical trial, but insurance won't pay for something experimental. The back of the napkin estimate for treatment is $350k, and it will take 17 days total. There's a lot of issues with the cost of cancer care.
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ijustwantadoughnut26 karma2020-10-19 15:33:42 UTC
I'm an oncology pharmacist. Lots of my patients decide not to tell their friends and family because they don't want to find out how they would behave. I have a couple of patients who I call weekly to check in because they don't have family who will check on them. I also had one patient whose family was so involved we had to use a special exam room to fit them all in for each of his appointments-- I have no idea how every child and child-in-law was able to get time of work for mid day appointments every other week, but they sure made it happen.
ijustwantadoughnut25 karma2020-10-19 15:23:50 UTC
I'm an oncology pharmacist. Our clinic has not been with withholding any pain treatment for fear of the DEA. We do have a few patients who feel we aren't treating their pain well enough, but in both cases it boils down to severe opioid use disorder and refusing to see a pain clinic. Oncology offices are equipped to deal with cancer pain, but when that is complicated by OUD, we need to call in the experts. None of my patients have been impacted by any manufacturing limits that may be going on. One challenge that has been noted in the oncology community is that people of color with end stage cancer will often receive much lower doses of opioids and end up in the emergency room for pain management. It's something we are addressing ... But it's sad that some folks still aren't getting pain treatment.
ijustwantadoughnut10 karma2020-10-19 18:53:56 UTC
It was terminal, but the patient had so much support. His family was very good about helping me keep track of some of his other medication issues and labs they had done in other clinics. Great family, great patient.
Not to say that having support will always make a difference in the patients care-- one patient has a support system that is extremely detrimental to her care. We are working on this, but the family is grieving and angry about the disease and can't focus on the patient. Just wanted to throw a shout-out to people who are going through cancer care alone. It's horrible, but I don't think it will worsen your prognosis.
ijustwantadoughnut9 karma2020-10-19 15:48:36 UTC
I work in a cancer center-- one thing many patients have told me is that their experience with cancer care workers (in my region and a few specialty centers we refer to) is generally better than other health care workers. (Shout out to the wonderful health care workers that don't do oncology but do provide amazing care! I know it's one bad experience that dampens a patient's opinion of the health care world).
I've wondered if caring for people with cancer attracts a certain kind of person? No one just lands in cancer care without some pretty hard work to get there. I hope most patients can relate to being treated well by their team.
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