Morning Read: The high cost of oral chemotherapy and its toll on patients

Highlights of the important and the interesting from the world of healthcare:

The high cost of oral chemotherapy and its toll on patients: More and more patients are being steered toward painful intravenous chemotherapy instead of expensive pills, which often represent much more advanced–not to mention a more pleasant–way of treating the disease. The problem lies in the peculiarities of the insurance reimbursement system, which typically treats IV chemotherapy as a benefit and oral chemotherapy pills as prescription drugs. Because prescription drug coverage is often much less generous, a number of patients are forced to go without the drugs that could make their cancer much more manageable, Kaiser Health News reports.

The situation has insurers and drugmakers sniping at each other over what the real problem is–that the drugs are so expensive or that insurers won’t cover them. But that doesn’t do much for patients who can’t afford the drugs they need to survive, particularly when there’s no intravenous alternative. Patients with myeloma, for example have two choices, according to one oncologist: “an oral drug or death.”

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Some myeloma patients need an oral drug called Revlimid, which can cost more than $7,000 per month, after an IV drug stops working. The pill enables some patients to continue working and to live normal lives. “Some of the saddest stories are patients who say, ‘I don’t want to die and leave my family with a bundle of debt,’ ” the oncologist said. “These are people with a lethal disease, and it is so, so stressful” for them to also wrestle with the question of how to afford potentially life-saving medication.

A problem in the ER: Emergency room doctors and other personnel are having an increasingly difficult time contacting patients about test results that indicate serious diseases or conditions, because many patients use fake names and phone numbers, MSNBC reports. Delayed test results also play a role. The problem has caused some ER workers to have to resort to people-finders, registered letters and law enforcement visits to deliver their diagnoses.

The typical situation involves a patient who arrives in the emergency room, undergoes tests and seems well enough to be discharged. But some tests take a day or two to complete and when the results come back, doctors realize there’s something to worry about. The detective work in tracking down patients obviously diverts hospital workers from other important tasks. Meanwhile, the New York Times reports that ERs are increasingly under pressure as patients show up with non-serious ailments like minor burns, sprains, ear infections and sore throats, all of which result in longer wait times for those who visit the ER with serious injuries.

The four deadly habits: British researchers tracked 5,000 adults for 20 years and identified four habits that can make people seem 12 years older than they actually are. See if you can guess the four (wait for it)–smoking, drinking, inactivity and a poor diet. The disparity in death rates between the healthiest and unhealthiest groups seems a little low, however. Of the 314 people who engaged in all four habits, 29 percent died. Of the 387 who engaged in none, only 8 percent died. Perhaps if researchers, check on the same people in another 10 or 20 years, the disparity will grow.