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Medicare Drug Plan Helps Patients Fight Cancer


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The new Medicare Prescription bill offers cancer patients benefits they did not have before, mainly coverage for oral-chemotherapy drugs.

The new legislation started the process of providing access to a full range of cancer-related prescription drugs at manageable costs to enhance the quality and standard of treatment for cancer. And I'm not just talking about addendum oral drugs. I'm also talking about many tried and true generic drugs.

There are over one hundred different therapeutic drug regimens, and some four hundred are in the pipeline. Any one or combination of them can help cancer patients. The system is overloaded with drugs and under loaded with wisdom and expertise for using them.

Compared with infusional therapy, oral-dose anti-cancer drugs can make receiving cancer treatment more convenient for patients by allowing flexibility in taking medication without disrupting work or other activities. That can often result in less time (or no time) spent in office-based oncology practices because of the absence of intravenous administration and its related side effects.

Our senior Americans with cancer may not even have to go to hospitals, let alone the infamous infusion-rooms of office based oncology practices. Because oral-dose is a pill, patients can take it at home with only occasional visits to the doctor, or hospital clinic. Standard chemotherapy is given into a vein and patients must visit the doctor or clinic dozens of times over the course of many weeks to be treated.

What the new Medicare Prescription bill did was to remove the profit incentive from the choice of cancer treatments, which were financial incentives for infusion-therapy over oral-therapy or non-chemotherapy, and financial incentives for choosing some drugs over others. Patients should receive what is best for them and not what is best for their oncologists.

A National Coalition for Cancer Survivorship (NCCS) poll found that 89% of Americans said that the distinction between oral and intravenous applications should be abolished so that Medicare beneficiaries can have access to the best drugs to treat their form of cancer.

Apparently, Medicare has gone far in accomplishing that task. Nearly all generic cancer drugs and 70% of brand-name cancer drugs are covered by the Part D plans. Most of the brand-name drugs not covered had generic equivalents that are covered. And a number of trusted, old (generic) agents have been found to be just as effacious as the more expensive brand name ones.

Many infusional therapies are typically biotechnology drugs made of complicated proteins that are injected. This makes them several times more expensive than traditional pill-form pharmaceuticals.

More chemotherapy is given for breast cancer than for any other form of cancer and there have been more published reports of clinical trials for breast cancer than for any other form of cancer. So, according to NCI's March 31, 2006 official cancer information website on "state of the art" chemotherapy for recurrent or metastatic breast cancer, it is unclear whether single-agent chemotherapy or combination chemotherapy is preferable for first-line treatment.

At this time, no data support the superiority of any particular regimen. So, it would appear that published reports of clinical trials provide precious little in the way of guidance. There are many cancer drug regimens, all of which have approximately the same probability of working. The tumors of different patients have different responses to chemotherapy. It requires individualized treatment based on testing the individual properties of each patient's cancer.

Cancers that can be treated with oral chemotherapy include, breast cancer, colon and colorectal cancer, Leukemia, chronic myeloid leukemia, chronic lymphocytic leukemia, acute promyelocytic leukemia, acute non-lymphocytic leukemia, Lymphoma, cutaneous T-cell lymphoma, small cell lung cancer, non-small cell lung cancer, Kaposi's sarcoma, prostate cancer, multiple myeloma, ovarian cancer, brain tumours.

Oral chemotherapeutic agents are easy to use and offer the promise of less frequent visits to oncology-based offices and their infusion rooms. This promise is not trivial, especially as we have come to realize that many forms of cancer may be managed with these drugs, especially when they offer the equivalent outcome as intravenous drugs.

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