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Oncology (General Cancer)/Cost of treatment per patient

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Question
Dear Dr Higby,

What is the rough average price per patient for cisplatin, oxaliplatin and taxol? How many courses on average does a patient receive and what is the rough price per course. (In America that is)

Many thanks for your help

EMilia

Answer
cisplatin -- 100-200 dollars per dose.  Oxaliplatin  1740 dollars for 50 mg.  Taxol  2100 dollars per 30 mg.  Those are extremely ball-park figures.  In fact, you can't find the cost of these drugs unless you go to foreign web sites.  That's because the drug companies negotiate with each insurance company and with medicare/medicaid.  Some of the companies negotiate a discounted price; this discount is often related to how much of the drug that company pays for in a year.  Also, the prices change (usually upwards) every few months.  When cisplatin first came out, it was about 25 dollars a dose.  
If you look at the bill from a chemotherapy infusion center, the average price for a course of these three drugs would be roughly four times the cost of the drugs themselves, and there would be other drugs given (anti emetics, steroids) and IV fluids.  So roughly 18,000 per month.  Of course no one actually pays that; that's the bill given to the insurance company, who then pay a negotiated fraction of the bill.  I didn't add in the "facility fee" which covers the use of the chemotherapy suite and the nursing personnel, the pharmacist, etc.  
Add to that the fact that there are patients who don't have insurance (and don't pay) and there are other patients where after the chemotherapy has been given, the insurance company decides that the medication will not be "covered" for some reason or another.  (Some insurance companies won't pay for chemotherapy given for advanced pancreatic cancer, for example).
I realize it's very confusing, and that is one of the bad things about the American medical system.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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