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Dr Marianne Fazen Explains How Coverage Decisions Factor Into Cancer Treatment Costs
There are more costs involved in cancer treatment than just the price of the drugs, said Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health. The process of selecting the right treatment also factors into spending, so it is important for patients to get a second opinion.
There are more costs involved in cancer treatment than just the price of the drugs, said Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health. The process of selecting the right treatment also factors into spending, so it is important for patients to get a second opinion.
Transcript (slightly modified)
What causes the biggest strain on healthcare spending when it comes to oncology: healthcare services or drug costs?
It isn’t only the spending, it’s mainly the specialty drugs. That’s the high cost of the treatment, the chemotherapy, but there’s a host of other issues that are costs that are involved besides just the $1000 or $1200 a month treatment that the patient requires.
It’s also coverage decisions: is it the most appropriate, the right drug or treatment for that particular patient, or are we just going through trial and error and testing to see, okay, we’ll try this because we usually try this with this patient. But maybe it’s not the right one, and so they have to go through all that emotional trauma of having to try the wrong medicine until they get to the right one. So genetic testing or even getting a second opinion is really important.
There’s another challenge that employers face, and not many employers know about second opinions and don’t cover second opinions.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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