Cancer is the leading cause of death in Colorado, with 44,527 dying from cancer in 2024; and nearly 26,000 new cancer diagnoses last year. People who live in areas with low household incomes — be it urban, suburban or rural — are more likely to be diagnosed with later stage disease, require more aggressive treatments, and have a poorer health outlook.
However, with rising costs of new cancer drugs, unaffordable treatments will not be confined to those without insurance or access to care. The ability to be treated may soon be out of reach for many patients and families.
Prescription drugs for cancer treatment are among the most expensive in the U.S., and the associated financial hardship for patients and families is well-documented. These drugs contribute to a widespread problem: medical debt.
Approximately 41% of American adults have medical debt, with many owing $2,000 or more. In Colorado, it’s closer to 11% because most Coloradans are insured.
The average price was $24,444 per month for cancer drugs approved between 2003 and 2022, with only modest improvements in survival. And, financial hardship can last years beyond diagnosis, treatment and can even shorten one’s survival.
Medicare, Medicaid and private payers pay the bulk of the cost for new cancer drugs. With looming cuts to federal and Colorado’s health care infrastructure, these payers will make choices between paying for expensive drugs or providing patients coverage for other health care needs. Fewer Coloradans may be covered, and fewer health care services will be provided.
My colleagues and I recently published a study that reported Medicare Advantage plans in Colorado are already less likely to prescribe high-cost treatments than Medicare fee-for-service plans when lower-cost drugs are available — foreshadowing what’s to come for patients on Medicare, Medicaid, and yes, those with private insurance.
Another recent study observed that following the availability of new, innovative therapies, patients experienced higher rates of debt in collection, tax liens, delinquent mortgage payments, foreclosures, repossessions and bankruptcy. This is presumably because they took on new debt or could not pay existing debts while undergoing cancer treatment.
Other financial setbacks can span generational divides, such as loans from family, depletion of savings, early withdrawal of retirement accounts, and the many daily sacrifices that are made to pay medical bills.
Americans may be reaching a limit on their ability to pay for innovative cancer therapies. The longer one lives with cancer the more likely debt is to occur. A sizable percentage of patients who die from cancer also have financial consequences and pass these consequences on to bereaved families.
Given the serious nature of financial events such as delinquent mortgage payments, I suspect another breaking point is on the horizon for Colorado patients and their families — willingness to continue treatment. The downstream impact of federal cuts to critical programs like Medicaid is expected to increase in the number of individuals without health insurance. The cancer patient in Carbondale is as much at risk as their counterpart in Loveland.
As reductions in health insurance coverage and health care infrastructure proceed, future studies will be needed to determine if fewer new therapies are prescribed, come to market, or experience a price reduction. Data will be needed to determine if the gains in cancer survival seen in past decades continue.
Regardless of whether we have the data or funding to study what happens after a cancer diagnosis, it is almost certain that financial hardship for patients and families will continue to rise among those diagnosed with cancer.
This is an opportunity for bold approaches to drug price negotiation that does not compromise innovation, a chance for Colorado to focus on prevention and early detection efforts that are effective and reduce the need for expensive treatment, and consider methods such as a genetic testing that better match drugs and cancer types so that patients do not suffer needlessly from physical, mental or financial consequences.
Cathy J. Bradley, Ph.D., is the dean of the Colorado School of Public Health and the deputy director of the University of Colorado Cancer Center. The opinions expressed here are hers and do not reflect an official position on behalf of the Colorado School of Public Health, University of Colorado or the CU Cancer Center.
The Colorado Sun is a nonpartisan news organization, and the opinions of columnists and editorial writers do not reflect the opinions of the newsroom. Read our ethics policy for more on The Sun’s opinion policy. Learn how to submit a column. Reach the opinion editor at opinion@coloradosun.com.
Follow Colorado Sun Opinion on Facebook.
Type of Story: Opinion
Advocates for ideas and draws conclusions based on the author/producer’s interpretation of facts and data.