Neuropathy Treatment Costs
Neuropathy is damage to or dysfunction of a nerve or group of nerves. Possible causes include injury or a system-wide problem such as diabetes or HIV infection. Symptoms can include pain, a loss of feeling in the affected area, tingling sensations, muscle weakness and paralysis.
Typical costs:
• For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays and copays or coinsurance of 10%-50%. Treatment for neuropathy typically is covered by insurance.
• For patients not covered by health insurance, treatment for neuropathy can cost less than $500 for over-the-counter or prescription pain reliever or a corticosteroid injection done in a doctor's office; it can cost $50-$350 per session -- or a total of hundreds or thousands of dollars -- for physical therapy; it can cost $1,000-$5,000 or more per year for epidural steroid injections, or for anticonvulsant medications prescribed to treat nerve pain. Surgery can cost $20,000-$90,000 or more, depending on the facility and the type of surgery.
• For example, Drugstore.com charges about $10-$12 for a one-month supply of a generic tricyclic antidepressant such as nortriptyline or amitripyline, which have been shown to relieve nerve pain in some patients. Drugstore.com charges about $20-$100 or more, depending on dose, for a one-month supply of the generic drug gabapentin, an anticonvulsant also used to treat neurological pain, and charges about $70-$400 or more, depending on dose, for the brand-name equivalent, Neurontin. Drugstore.com charges about $100-$250 or more for a one-month supply of the anticonvulsant medication Lyrica, also used for neurological pain. Physical therapy typically costs from $50-$350 per session. According to Medscape.com, an epidural steroid injection for spinal stenosis typically costs about $2,200.
• Dartmouth-Hitchcock Medical Center charges about $7,600, after a 30% uninsured discount, for a carpal tunnel release surgery.Saint Elizabeth Regional Medical Center charges about $12,000-$16,000, not including doctor fee, for a laminotomy, a surgery that removes part of the lamina, the bony layer covering the spinal cord. Herniated disc surgery costs $20,000-$50,000 or more. And a laminectomy, which removes the lamina completely, typically costs $50,000-$90,000.
Diabetic Wound Care Treatment Costs
A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 15 percent of patients with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.
Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States, and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer have an amputation.
Typical costs:
• Every year in the US, more than 1.3 million patients develop diabetic ulcers, and up to one-quarter of them will eventually require an amputation. The cost to treat these patients exceeds $5 billion, plus another $1 billion on related amputations.
• A study in 2014 was performed in which a post-hoc retrospective analysis of patients enrolled in a randomized controlled trial to evaluate overall costs of negative pressure wound therapy (NPWT; V.A.C. Therapy; KCI USA, Inc, San Antonio, Texas) versus advanced moist wound therapy (AMWT) in treating grade 2 and 3 diabetic foot wounds during a 12-week therapy course. METHODS: Data from two study arms (NPWT [n = 169] or AMWT [n = 166]) originating from Protocol VAC2001-08 were collected from patient records and used as the basis of the calculations performed in our cost analysis. RESULTS: A total of 324 patient records (NPWT = 162; AMWT = 162) were analyzed. There was a median wound area reduction of 85.0% from baseline in patients treated with NPWT compared to a 61.8% reduction in those treated with AMWT. The total cost for all patients, regardless of closure, was $1,941,472.07 in the NPWT group compared to $2,196,315.86 in the AMWT group. In patients who achieved complete wound closure, the mean cost per patient in the NPWT group was $10,172 compared to $9,505 in the AMWT group; the median cost per 1 cm(2) of closure was $1,227 with NPWT and $1,695 with AMWT. In patients who did not achieve complete wound closure, the mean total wound care cost per patient in the NPWT group was $13,262, compared to $15,069 in the AMWT group. The median cost to close 1 cm(2) in wounds that didn't heal using NPWT was $1,633, compared to $2,927 with AMWT. CONCLUSIONS: Results show greater cost effectiveness with NPWT versus AMWT in recalcitrant wounds that didn't close during a 12-week period, due to lower expenditures on procedures and use of health-care resources.
• Another study from 2012 shows the average cost of treating a chronic wound is $10,376, average cost of acute wound (no complications) is $11,840 and the average time to closure of acute wound (no complications) is 165 days.
Amputation Cost
Surgical amputation due to complications from diabetes.
Typical costs:
• For patients not covered by health insurance, the typical cost of an amputation ranges from $20,000 to $60,000 including the surgeon's fee, facility fee, anesthesia and medical supplies. The cost depends partly on the part of the body being amputated; a toe amputation would be at the lower end of the cost range, while an above-the-knee amputation would be at the higher end.
• Amputation surgery generally is covered by health insurance, often even in cases where a patient chooses to undergo the surgery because of pain or a limb that is not useful.
• For patients covered by health insurance, typical out-of-pocket costs would include a copay or coinsurance for an inpatient surgery of 10 to 20 percent or more of the total cost, which would stop at the annual out-of-pocket maximum.
Additional costs:
• After amputation, physical therapy is necessary.
• Many patients who undergo amputation have a prosthesis made. The cost of a prosthesis ranges from a few thousand dollars for a very basic prosthetic limb to more than $40,000 for a more high-tech limb with a computer chip. Many health insurance companies have very low caps on the amount they will pay for prosthetics, so many patients end up paying out-of-pocket. Prosthetic limbs also wear out and have to be replaced.
Psoriasis Treatment Costs
Psoriasis is a common, non-contagious inflammatory condition that results in itchiness, redness, flaky patches and thickening on the skin. It can appear anywhere on the body but occurs most often on knees, elbows and trunk.
Typical costs:
• For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays of $5-$50 or more, or coinsurance of 10%-50% -- which can reach $500 or more for certain drugs. According to the National Psoriasis Foundation, copays for phototherapy can be $50 or more per session. Treatment for psoriasis typically is covered by insurance, but certain medications might not be covered in some cases. For example, Aetna's clinical policy bulletin on biologic therapies for psoriasis states that some medications are covered only when certain criteria are met, including other treatments having failed.
• For patients not covered by health insurance, psoriasis treatment typically costs about $100-$1,000 or more per month for topical creams and ointments or for traditional oral medications. The cost depends on the medication and the amount used. For example, Drugstore.com charges about $65 for a tube of DermaTop corticosteroid ointment. It charges about $80 for a tube of betamethasone-dipropionate, a generic corticosteroid ointment. It charges about $120 for a tube of Dritho-Scalp a topical medication that slows skin growth. Drugstore.com charges about $220 for a tube of Tazarotene, a retinoid cream that slows skin growth. It charges about $360 for a tube of Dovonex, a synthetic vitamin D3 analog that slows skin growth and removes flaky skin. Drugstore.com charges about $45 for a one-month supply of methotrexate tablets. It charges about $360 for a one-month supply of generic cyclosporine oral immunosuppressant medication. It charges $950 or more for a one-month supply of Soriatane, a brand-name oral retinoid.
• And psoriasis treatment typically costs about $2,000-$6,000 or more for phototherapy -- or up to $11,000 for initial treatment, then $1,000-$2,000 per month afterward, for newer biologic medications. For example, the national average cost per session for phototherapy is about $63, with a total of $3,780 or more for a typical 30 weeks of twice weekly treatment. Or, some patients buy a home unit for about $2,000-$6,000 or more. And Drugstore.com charges about $1,900 for a one-month supply of syringes filled with the biologic Enbrel. (Enbrel would cost $11,400 total for the first three months of treatment, then $1,900 per month afterward.) Biologics might be used in severe, debilitating cases that have not responded to other treatments.
What should be included:
• Psoriasis typically can be diagnosed based on symptoms and a visual examination. In some cases, a skin biopsy might be required.
• The doctor typically will first prescribe a topical cream, ointment or shampoo to remove flaky skin and control redness and itching. The National Psoriasis Foundation has a guide to topical psoriasis treatments.
• In some cases, the doctor might prescribe phototherapy, either alone or in conjunction with a medication.
• In severe cases where other treatments do not work, a doctor might prescribe either a traditional oral systemic medication such as methotrexate or cyclosporine. Or, the doctor might prescribe a newer biologic drug, which is made from laboratory-cultured cells. These drugs include etanercept (brand name Enbrel), which is given at home by subcutaneous injection, usually twice a week for three months, then once a week, or Infliximab (brand name Remicade) which is injected intravenously in a doctor's office -- usually three times over six weeks, then once every two months.
Additional costs:
About 5% of people with psoriasis develop psoriatic arthritis. Treatment
for psoriatic arthritis typically involves some of the same traditional or
biologic oral drugs that are sometimes used to treat psoriasis and can cost
hundreds or thousands of dollars per month, depending on the drug.
Multiple Sclerosis Treatment Costs
Multiple sclerosis is a progressive autoimmune disease in which the immune system attacks the protective sheath around the nerves. Eventually patients can have trouble performing daily tasks, speaking and walking. The age of onset is commonly between 20 and 40, and the disease is more common in women. Treatments can lessen symptoms and slow progress of the disease.
Typical costs:
• For patients covered by health insurance, out-of-pocket costs for multiple sclerosis treatment typically consist of doctor visit, lab and prescription drug copays of 10%-50%. Multiple sclerosis treatment typically is covered by health insurance, although individual drugs or treatments might not be covered by some plans.
• For patients not covered by health insurance, multiple sclerosis treatment costs can range from less than $15,000 to $50,000 or more per year. Cost typically is on the higher end for patients who take drugs designed to slow progress of the disease.
• For example, at DrugsDepot.com, the brand-name drug Avonex, taken once a week by injection into the muscle, costs more than $3,900 for a one-month supply -- or a total of more than $47,000 a year. According to a study in the Journal of Medical Economics, the drug natalizumab (brand name Tysabri) costs a little over $43,000 per year, and the drug fingolimod (brand name Gilenya) costs a little over $49,000 a year. At DrugsDepot.com, the brand-name drug Gilenya costs almost $4,500 per month, for a total of $54,000 per year.
• According to one study, the average direct medical cost of multiple sclerosis was almost $13,000, but costs were higher -- from about $17,000 to $22,000 on average -- for patients who take drugs designed to slow progress of the disease. According to a study by pharmacy benefits manager Prime Therapeutics, the average specialty drug for multiple sclerosis costs about $30,000 a year and is steadily rising, while all other health care costs about $13,000 -- for a total of almost $43,000 a year.
What should be included:
• The primary treatment used for multiple sclerosis is drug therapy. A doctor might recommend beginning drug therapy soon after diagnosis to slow the progression of the disease and possibly prevent some nervous system damage. Drugs often prescribed include: Avonex, a beta interferon injected into the muscle and used to slow progress of the disease. And the drug Copaxone, administered via injection under the skin, can interfere with the immune system's ability to attack the nerve sheath, reducing the number of attacks. The drug Gilenya, taken as a daily pill, helps contain immune system cells to reduce the number of attacks. The oral medication Aubagio also can reduce attacks.
• When a patient with a relapsing form of MS experiences a relapse -- also called an attack or a flare-up -- corticosteroids typically are prescribed to reduce inflammation and lessen the severity of the flare-up. These drugs can be given in oral form or via a four-to-five-day course of IV treatment.
• Many MS patients also require physical therapy and occupational therapy.
Cancer Treatment Costs:
Brain Cancer Treatment Costs
Typical costs:
• For patients covered by health insurance, the typical cost of brain tumor treatment will include doctor copays, drug copays and coinsurance of 10-50% or more -- most likely reaching the yearly out-of-pocket maximum. Brain tumor treatment typically is covered by health insurance.
• For patients not covered by health insurance, the typical cost of brain tumor treatment can range from less than $50,000 for a small benign tumor in an accessible location that can be treated with surgery alone up to $700,000 or more for a malignant tumor that must be treated with some combination of surgery, radiation and chemotherapy. For example, the cost of brain surgery is typically $50,000-$150,000 or more. Dartmouth-Hitchcock Medical Center in New Hampshire charges about $72,500 for brain surgery, including hospital charge and doctor fees, after a 30% uninsured discount. Saint Elizabeth Medical Center in Nebraska charges about $33,600-$78,700, not including doctor fees. And Baptist Memorial Healthcare in Memphis charges almost $50,000 without major complications to almost more than $110,000 with major complications, not including the doctor fees, which can add up to $30,000 or more to the final bill.
• Stereotactic radiosurgery, a type of radiation therapy commonly used on brain tumors, typically costs $12,000-$55,000; however, additional treatments sometimes are required for recurring or new tumors, so total costs can easily reach $100,000 or more. The cost of chemotherapy varies widely based on the drug, how it is administered and how many treatments are required -- and costs commonly reach tens of thousands of dollars.
• The Brain Tumor Foundation estimates the cost of treating a glioblastoma at more than $450,000 and says costs of treating a brain tumor can reach $700,000 in a lifetime.
What should be included:
• In surgery, the most common treatment for a brain tumor, the patient is placed under general anesthesia and the surgeon performs a craniotomy, cutting into the skull to access the brain. After surgery, the patient typically must stay in the hospital for three to six days and take several weeks off from work. HopkinsMedicine.org offers an overview of the different types of craniotomy and the types of brain tumors each one typically is used to treat.
• Radiation therapy might be used in conjunction with surgery, with chemotherapy, or alone. In conventional radiation therapy, partial doses of radiation are delivered to the brain, usually once a day for about six weeks. In Stereotactic radiosurgery, which can sometimes be used on tumors deemed inoperable, the doctors uses 3-D computer images of the brain to target multiple beams of high doses of radiation directly into the tumor. Typically, between one and five treatments are needed.
• Chemotherapy, which usually is used for cancerous brain tumors, typically either kills cancer cells or inhibits their ability to reproduce.
Additional costs:
After brain surgery, a patient might need physical therapy, speech therapy
or occupational therapy. This can cost hundreds of dollars per session —
and can total thousands or tens of thousands of dollars or more.
Breast Cancer Treatment Costs
Breast cancer treatment usually involves surgery -- a lumpectomy or mastectomy -- sometimes followed by chemotherapy, radiation or other treatments.
Typical costs:
• For patients covered by health insurance, out-of-pocket costs for breast cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. Breast cancer treatment typically is covered by health insurance, although some plans might not cover individual drugs or treatments.
• For patients not covered by health insurance, breast cancer treatment typically costs $15,000-$50,000 or more for a mastectomy or $17,000 to $35,000 or more for a lumpectomy followed by radiation.
• Chemotherapy can cost about $10,000-$100,000 or more, depending on the drugs, the method of administration and the length or number of treatments. For example, women on a BreastCancer.org forum report chemotherapy costs of $7,000-$40,000 per treatment.
• Depending on the individual case and the type and number of treatments needed, the total cost of breast cancer treatment, on average, can reach $100,000 -- or, in advanced cases, $300,000 or more. In a BreastCancer.org forum, patients discuss total costs of their breast cancer treatment. For example, a study published in BMC Cancer found that the average total cost of care over a mean follow-up of 532 days was about $128,500 for women with metastatic breast cancer receiving chemotherapy as their primary treatment. This includes the cost of the chemotherapy drugs, additional drugs to help manage side effects, administration of the drugs and medical care for chemotherapy-related complications.
What should be included:
• Most breast cancer patients undergo surgery -- either a lumpectomy, a partial mastectomy, a simple mastectomy or a modified radical mastectomy. (A radical mastectomy usually is not performed because a modified radical mastectomy removes less tissue and is about as effective.) The type of surgery performed typically depends on the size and stage of the cancer and other factors.
• Some breast cancer patients undergo radiation therapy, either after surgery to reduce the chance of recurrence, as an alternative treatment if surgery cannot be performed, or if the cancer has spread.
• Some patients undergo oral or IV chemotherapy, before surgery to help shrink the tumor, after surgery, or if surgery cannot be performed.
• Patients whose breast cancer cells have estrogen or progesterone receptors may undergo hormone therapy, to inhibit the cancer cells' growth.
• The National Cancer Institute offers an overview of breast cancer treatments.
Additional costs:
• If a mastectomy is required, the patient might choose to get breast reconstruction. This typically costs $5,000-$15,000 or more per breast for implants or from $25,000-$50,000 or more per breast for "flap" techniques using tissue from the patient's own body.
• Breast cancer patients will need regular follow-up doctor visits and screenings to check for recurrence. The American Society of Clinical Oncology offers guidelines for follow-up care that include doctor visits every three to six months for the first three years, and a mammogram, which costs about $100, every six to 12 months.
Lung Cancer Treatment Costs
Lung cancer, or cancer that starts in the lungs, is the leading cause of cancer death in the United States, with smokers at greatest risk for contracting the disease. According to the National Institutes of Health, lung cancer is more common in older adults and rarer in people 45 or younger.
Typical costs:
• For patients covered by health insurance, out-of-pocket costs for skin cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. Lung cancer treatment typically is covered by health insurance, although some plans might not cover individual drugs or treatments.
• According to the American Cancer Society, the cost of cancer treatment depends on the type and duration of treatment, and whether the patient is treated at home, in a clinic, in the doctor's office, or in the hospital.
• For lung cancer in particular, treatment typically involves one or more of the following options, alone or in combination: surgery which can cost $15,000 or more; chemotherapy, which can cost $10,000 -$200,000 or more; radiation therapy, which can cost $10,000-$50,000 or more; and/or drug therapy, which can cost as much as $4,000 or more a month depending on the drug used. For instance, ranibizumab (Lucentis) costs about $1,600 a dose, while Erlotinib (Tarceva) costs $3,500 a dose.
• One study on the economic burden of lung cancer estimates that the overall costs, from diagnosis to a maximum of two years thereafter, to be about $46,000. The study found that the main cost drivers were hospitalization (49% of costs) and outpatient office visits (35.2% of costs), with a monthly initial treatment phase cost of $11,500 per patient.
• The Agency for Healthcare Research and Quality reports that patients with lung cancer are typically hospitalized for 7 days at a cost of $15,600 total, or $2,200 per day.
• If it appears unlikely that the condition can be cured, a doctor may recommend that a patient avoid harsh treatments and opt for supportive care instead. One recent study found that patients who received palliative care incurred, on average, $6,900 less in hospital costs during a given admission than patients who received usual care. Most insurance plans cover palliative care.
What should be included:
• Patients who experience symptoms may undergo a series of tests to detect cancerous cells, including an MRI or X-ray.
• According to the Mayo Clinic, a patient and doctor develop a treatment plan based on a number of factors, including overall health, the type and stage of cancer, and patient preferences.
Additional costs:
• According to a study published in the international journal Lung Cancer, the failure of initial treatment is associated with markedly increased costs. Patients needing additional rounds of treatment had total costs of $120,650, compared to $45,953 for those receiving initial treatment only.
Prostate Cancer Treatment Costs
Prostate cancer treatment can range from watchful waiting to surgery, radiation therapy and hormone therapy, which blocks the male hormones that can contribute to prostate cancer growth.
Typical costs:
• For patients with health insurance, out-of-pocket costs for prostate cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures. Prostate cancer treatment typically is covered by health insurance, although some plans may not cover certain drugs or treatments.
• For patients without health insurance, the cost of prostate cancer treatment can vary widely depending on the individual case. For very early stage prostate cancer, a watchful waiting approach could cost less than $10,000 over a five-year period, while costs for advanced prostate cancer treatment could reach $50,000-$100,000 or more.
• For example, Straub Clinic & Hospital in Hawaii charges slightly less than $20,000 for removal of the prostate, including an uninsured discount. But the price drops to less than $14,000 if the bill is paid in full in 90 days, or less than $12,000 if paid in 30 days. Saint Elizabeth Regional Medical Center in Nebraska charges about $11,000- $18,000, not including the doctor fee, for removal of the prostate. The hospital charges more than $20,000 for removal of regrowth of prostate tissue. Radiation therapy for prostate cancer cost $12,000-$40,000.
• According to the American Cancer Society, prostate cancer costs, on average, about $4,300 initially and about $9,100 over five years, for watchful waiting. It costs about $15,000 initially and $19,000 over five years for surgery. It costs about $17,500 initially and $25,000 total over five years for hormone therapy with radiation. For patients with advanced prostate cancer, costs can reach $100,000 or more.
What should be included:
• In some cases, especially for older patients or those with other health problems, a doctor might recommend watchful waiting or active surveillance.
• Surgery often is recommended for early-stage prostate cancer. Sometimes, radiation therapy is used alone or with surgery, especially if the surgery failed to remove all of the cancer.
• When the cancer has spread or other treatments failed, chemotherapy often is recommended. Typically, only one drug will be used. Drugs sometimes used to treat prostate cancer include Docetaxel, Cabazitaxel, Mitoxantrone and others.
• For prostate cancer that has spread, hormone therapy might be recommended. This can range from surgery to remove one or both testicles to drugs that curtail the production of male hormones in order to slow cancer growth.
• Cancer.gov offers an overview of prostate cancer treatment.
Additional costs:
• Prostate cancer patients will need regular follow-up doctor visits and screenings to check for recurrence. A PSA test costs about $20, with an additional $25-$100 for a doctor visit. According to the American Society of Clinical Oncology, follow-up costs for the first two years after treatment averaged about $1,000 in one group of patients.
Cervical Cancer Treatment Cost
Typical costs:
• For patients with health insurance, out-of-pocket costs for cervical cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can reach the yearly out-of-pocket maximum. Cervical cancer treatment typically is covered by health insurance, although some plans may not cover certain drugs or treatments.
• For patients without health insurance, cervical cancer treatment cost can range from less than $2,000 for a procedure to remove pre-cancerous or cancerous cells from the cervix, to $100,000 or more for advanced cases in which the cancer has spread and surgery and chemotherapy are required.
• For example, the cost for loop electrosurgical excision procedure (LEEP) to remove precancerous, or sometimes cancerous cells, at NOVA Women's Health Care, in Virginia, costs $1,500 -- or $1,700 with deep sedation. Patients on a forum at DailyStrength.com report costs ranging from $500 to $1,500. A hysterectomy, a surgery to remove the uterus which is sometimes recommended to treat cervical cancer, typically costs $10,000-$20,000 or more.
• Chemotherapy often is combined with radiation for treating advanced cervical cancer. Chemotherapy typically costs $10,000-$200,000, depending on which drugs are used, how they are administered and the number of treatments required. A study published in the journal Gynecologic Oncology reports that a commonly used treatment for cervical cancer, the chemotherapy drug Cisplatin combined with radiation, typically costs about $40,000 total, while adding the drug Gemcitabine increased the total cost to more than $60,000.
• According to a study on cervical cancer treatment costs by the Jacobs Institute of Women's Health, total cervical cancer treatment costs for Medicaid recipients, for the first six months after diagnosis, ranged from just under $4,000 to more than $45,000, depending on whether and how far the cancer had spread.
Pancreatic Cancer Treatment Cost
Typical costs:
• For patients with health insurance, out-of-pocket costs for pancreatic cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. Pancreatic cancer treatment typically is covered by health insurance, although some plans may not cover certain drugs or treatments.
• For patients without health insurance, pancreatic cancer treatment typically costs about $50,000-$200,000 or more, depending on the type and length of treatment.
• For example, according to Vimo.com, a health care cost comparison website, Barnes Jewish Hospital in Missouri charges more than $40,000 for the Whipple procedure, a common surgery for pancreatic cancer. That cost can reach $85,000 or more with the addition of non-surgical care.
• According to the American Society of Clinical Oncology, a six-month course of Gemcitabine, the chemotherapy drug typically used to treat advanced pancreatic cancer, costs about $23,500. Adding the drug Erlotinib, which might increase survival time slightly, adds more than $16,500, for a total of more than $40,000. A study published in the journal Cancer found that stereotactic body radiotherapy, used in addition to chemotherapy, added $13,700 to the total treatment cost.
• According to the American Society of Clinical Oncology, the average cost of care for newly diagnosed pancreatic cancer patients was more than $8,000 a month. A patient on the Cancer Survivors Network forum reports total costs of more than $200,000.
What should be included:
• In some cases, treatment for pancreatic cancer will involve surgery. One common surgery for pancreatic cancer is the Whipple procedure, in which the head of the pancreas, the gallbladder, the bile duct and possibly some lymph nodes are removed. This involves general anesthesia and a hospital stay of a week or two.
• In other cases, doctors perform a distal pancreatectomy, in which the tail of the pancreas is removed. If there are tumors in the entire pancreas, a total pancreatectomy might be recommended.
• In many cases, especially when the tumor cannot be completely removed by surgery, chemotherapy will be recommended. Gemcitabine is the most common chemotherapy drug for pancreatic cancer. One targeted therapy, Erlotinib, has been approved and other new therapies are being investigated.
• Depending on the individual case and the type of pancreatic cancer, radiation therapy might be recommended after surgery or in conjunction with chemotherapy.
Fibromyalgia Treatment Cost
Fibromyalgia is a common syndrome, particularly among women, that's characterized by long-term and widespread pain throughout the joints, muscles, tendons and other soft tissues. It has been linked to fatigue, irritable bowel syndrome, and problems with sleep, mood and memory. Though fibromyalgia is not fully understood, researchers suspect it may be triggered by abnormal pain responses in the brain, infection or trauma, among other possible causes. There's no cure, but medications and lifestyle changes may help minimize symptoms.
Typical costs:
• Fibromyalgia sufferers seeking medical treatment would start with an office visit to a primary care physician, which is typically covered by health insurance. For insured patients, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10-50% or more. For uninsured patients, an office visit typically costs $50-$200 or more. If necessary, a primary care physician may refer the patient to a rheumatologist.
• Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are approved specifically for the treatment of fibromyalgia. For patients not covered by health insurance, these can range in cost from nearly $90-$200 for a 30-day supply. For patients with health insurance, out-of-pocket costs will typically include a coinsurance of up to 20% or copay of $35. A doctor may also prescribe an antidepressant or anti-seizure drug to help ease pain or fatigue.
• In addition, a doctor may recommend over-the-counter aids such a Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen which cost about $5-$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent.
• Physical therapy or cognitive behavioral therapy may help patients better cope with symptoms. For uninsured patients, physical therapy typically costs $50 -$350 or more per session, while a one-hour session of cognitive behavioral therapy typically starts at $125 and can cost more than $250. For insured patients, out-of-pocket costs for these therapies typically include a copay of $10-$75 per session or coinsurance of 10%-50% or more.
What should be included:
• During the office visit, a doctor will conduct a tender points exam, which looks for specific areas that are usually sensitive to the touch among fibromyalgia sufferers. To be diagnosed with fibromyalgia, a patient must have had at least three months of widespread pain and pain and tenderness in at least 11 of 18 specified areas, including the knees, lower back, neck, elbows and rib cage.
• There are currently no diagnostic laboratory tests for fibromyalgia, but a doctor may conduct blood, urine, or other tests to rule out other conditions.
Additional costs:
• Because many of the symptoms of fibromyalgia are similar to other disorders, patients may need to see several doctors before receiving a diagnosis.
• Some patients use alternative therapies such as acupuncture, which typically costs $75-$95 for an initial visit. However, it's been difficult for researchers to determine how well these therapies really work.
Epstein-Barr Virus (EBV) Treatment Costs
The Epstein-Barr virus (EBV), a member of the herpesvirus family, is found throughout the world. Studies show that up to 95% of all adults have antibodies against this common virus, meaning that they were infected at some point in their lives. Even though most infections with EBV go unnoticed or produce only very mild symptoms, in some cases, it can be associated with the development of serious conditions, including several types of cancer. Even mild or non-life-threatening infection with EBV can, occasionally, be associated with the development of serious complications from the infection. Although the virus typically targets lymphocytes, a particular blood cell involved in the immune response, almost all organs systems can ultimately be affected by EBV infection.
EBV is transmitted by close person-to-person contact. Primary, or initial, infection with EBV may not produce symptoms or there can be a number of different symptoms, especially in young children. The manifestations of primary EBV infection include:
Infectious mononucleosis (IM): This is the most common medical condition associated with EBV. IM is characterized by extreme fatigue, tonsillitis and/or inflamed throat (pharyngitis), enlarged, tender lymph nodes in the neck, and moderate to high fever. Although the fever and sore throat typically resolve within two weeks, fatigue may persist for months after the infection.
Other mild childhood illnesses: EBV infection in young children has also been linked to ear infections, diarrhea, other gastrointestinal symptoms, and cold symptoms in addition to the classic symptoms of IM.
In rare cases, primary infection with EBV has been associated with neurologic disturbances including Guillain-Barre syndrome and meningoencephalitis. Other rare manifestations of primary infection are abnormalities of the blood or coagulation systems such as anemia, thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome (TTP/HUS), and disseminated intravascular coagulation (DIC).
Typical costs:
There is no specific medicine to treat mononucleosis. Some physicians use corticosteroids to treat significant swelling in the throat or an enlarged spleen, but steroids are not needed in most people. Antiviral medications are available to help oral hairy leukoplakia, including acyclovir (Zovirax), ganciclovir (Cytovene), and foscarnet (Foscavir).
Crohn's Disease Treatment Cost
Crohn's disease is one in a group of chronic conditions referred to as inflammatory bowel disease, which are characterized by inflammation of all or part of the digestive tract. In Crohn's disease, the part of the digestive tract typically affected is the end portion of the small intestine, called the ileum. Crohn's disease can be debilitating, and may lead to life-threatening complications. The exact cause of the condition is unknown.
Typical costs:
• Patients seeking medical care for Crohn's disease would start with an office visit to a primary care physician, which is typically covered by health insurance. For patients covered by health insurance, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10%-50% or more. For patients without health insurance, an office visit typically costs $50-$200 or more.
• Drug therapy is typically the first course of action. For moderate to severe cases of Crohn's, a doctor may prescribe one or more kinds of drugs to curb inflammation and manage symptoms, including aminosalicylates, corticosteroids, or immune system suppressors. These medications can cost $20-$900 or more, depending on the type and dose of drug needed, and whether the medicine is available in generic form.
• According to WebMD many patients are first treated with the anti-inflammatory drug sulfasalazine, which typically costs about $21. The immune system suppressor Infliximab (Remicade), which may be recommended if other drugs fail, costs about $900 for a 100 mg dose.
• If drug therapy and lifestyle changes fail, a surgical procedure called a bowel resection may be performed. At Saint Elizabeth Regional Medical Center in Lincoln, NE, major bowel procedures like this typically cost $30,000 or more. According to a study that examined costs related to IBD conditions, the average total cost of hospitalization is $35,378.
• Over-the-counter medications may help to alleviate mild pain or other symptoms, such as diarrhea or constipation, and typically cost $4-$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent. For example, six tablets of the anti-diarrheal Loperamide (Imodium) costs about $5, while 44.2 oz of the fiber supplement psyllium powder (Metamucil), costs $15. Insurers do not typically pay for nonprescription medicines.
What should be included:
• After an initial evaluation, a primary doctor will likely refer patients exhibiting symptoms to a gastroenterologist for more detailed testing to rule out other possible conditions. This may include diagnostic exams such as blood tests, a colonoscopy or an X-ray of the abdominal area.
• The goal of treatment is to reduce inflammation, and drug therapy is typically the first course of action. If lifestyle changes, drug therapy, or other treatments don't relieve symptoms, a bowel resection may be recommended. During surgery, the damaged portion of the digestive tract is removed and the healthy sections are reconnected.
• According to the Mayo Clinic, as many as three out of four people with Crohn's disease will eventually need some type of surgery. Moreover, since Crohn's typically recurs elsewhere in the digestive tract, the benefits of surgery are usually temporary, and many patients will later need a second procedure or more.
Additional costs:
• Since IBD patients often have reduced bone density, either from decreased calcium absorption or as the result of using certain medications, a doctor may recommend taking a calcium supplement. Calcium supplements typically cost $4-$25. For example, 150 tablets of Caltrate costs $14 for 150 tablets.
• Because stress can aggravate symptoms, therapies that help patients manage negative emotions or reduce anxiety such as massage may help to prevent IBD conditions from worsening.
Irritable Bowel Syndrome Treatment Cost
Irritable bowel syndrome is a disorder of the large intestine that is characterized by cramping, bloating, constipation, and diarrhea. Its causes are unknown. Though IBS typically creates discomfort, it does no permanent harm to the intestines. Most IBS patients can manage their symptoms with lifestyle changes and prescribed medications, but for a minority of patients the condition can be disabling.
Typical costs:
• Patients seeking medical care for IBS would start with an office visit to a primary care physician, which is typically covered by health insurance. For patients with health insurance, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10%-50% or more. For patients without health insurance, an office visit typically costs $50-$200 or more.
• Over-the-counter aids to help control IBS symptoms such as constipation and diarrhea typically cost $4-$25 depending on the quantity and whether the patient buys a name brand or its generic equivalent. For example, 120 capsules of the fiber supplement psyllium (Metamucil) costs $14,while six caplets of the anti-diarrheal OTC medication loperamide (Imodium) costs $5.
• For moderate to severe cases, a doctor may prescribe one or more kinds of drugs to manage symptoms, including anticholinergic medications, antidepressant medications, or antibiotics. Prescription medications used to treat IBS typically range in cost from $10-$200. For example, the anticholinergic medication dicyclomine (Bentyl), which is used to counter bowel spasms, typically costs $49 or less without health insurance, while generic Imipramine hcl (Tofranil), an antidepressant, typically costs $16. For patients covered by health insurance, the typical out-of-pocket cost for drugs is a prescription drug copay of $5-$30 or more.
What should be included:
• An IBS diagnosis is generally based on a complete medical history and physical examination.
• After an initial evaluation, a primary doctor may refer patients exhibiting symptoms to a gastroenterologist for more detailed diagnostic testing. No specific test for IBS exists, but certain exams, such as a colonoscopy, may help to rule out other problems.
Additional costs:
• Because stress can trigger colon spasms in IBS patients, therapies that help to manage negative emotions or reduce anxiety such as massage may help to keep symptoms from worsening.
Ulcerative Colitis Treatment Cost
Ulcerative colitis is a chronic inflammatory bowel disease that causes ulcers to form on the inner lining of the colon and rectum, leading to bleeding and diarrhea. The condition can be debilitating and may even result in life-threatening complications. Though the cause of ulcerative colitis is unknown, it is possible to reduce symptoms or bring about long-term remission with treatment.
Typical costs:
• Treatment for ulcerative colitis is typically covered by health insurance. For patients with insurance, out-of-pocket costs typically consist of a specialist copay, possibly a hospital copay of $100 or more, and coinsurance of 10%-50% for the procedure, which could reach the yearly out-of-pocket maximum.
• A doctor may prescribe one or more kinds of drugs to control symptoms, including anti-inflammatory medications and immune system suppressors. Medications used to manage ulcerative colitis typically cost $20-$900 or more, depending on the type and dose of drug needed, and whether the medicine is available in generic form. For example, the generic version of the anti-inflammatory drug sulfasalazine costs about $21; a suppository of Canasta, a brand name version of the anti-inflammatory drug mesalamine costs $583; and the immune system suppressor Infliximab (Remicade) costs about $900 for a 100 mg dose.
• Some patients may need to have a proctocolectomy, surgery in which the colon and rectum are removed, followed by an ileoanal anastomosis, in which a surgeon uses the end of the small intestine to construct a pouch for holding stool. A 2009 National Institutes of Health study found that the mean cost of this type of procedure was $39,309. At Saint Elizabeth Regional Medical Center in Lincoln, NE, a partial proctocolectomy alone costs $12,364.
What should be included:
• Ulcerative colitis patients would typically start by first seeing a family doctor or a general practitioner who may then refer them to a gastroenterologist. Diagnostic exams may include blood tests, a colonoscopy or an X-ray of the abdominal area.
• Medication, whether oral or topical, is typically the first line of treatment. Patients who receive treatment often see symptoms improve after three weeks, with up to 90% going into remission.
• If lifestyle changes and medication don't relieve symptoms, a surgical procedure may be needed. According to the National Institute of Diabetes and Digestive and Kidney Diseases, some 10%-40% of ulcerative colitis patients eventually need a proctocolectomy.
• Following a proctocolectomy, most patients need to remain in the hospital for 1 to 2 weeks, and full recovery can take 4 to 6 weeks.
Additional costs:
• According to the Mayo Clinic, because ulcerative colitis can interfere with the body's ability to absorb nutrients, vitamin and mineral supplements may be needed. Supplements typically cost $5-$25 or more depending on the quantity and whether the patient buys a name brand or its generic equivalent.
• Because stress can aggravate symptoms, therapies that help manage negative emotions or reduce anxiety such as massage may help some patients to improve their condition.
Colonoscopy Cost
A colonoscopy is a screening test for colon cancer. It is recommended that people of average risk get a colonoscopy or other type of screening every 10 years starting at age 50. People at high risk should begin screening earlier, and sometimes more often, according to the American Cancer Society.
Typical costs:
• For those not covered by health insurance, the cost of colonoscopy varies by provider and geographic region, usually ranging from $2,010 to $3,764, with an average of $3,081, according to Blue Cross Blue Shield of North Carolina.
• A colonoscopy often is covered by health insurance if the patient has symptoms that warrant it or if the patient meets age and risk criteria. According to the 2012 Colorectal Cancer Legislation Report Card, 31 states have laws mandating colonoscopy coverage.
• For patients covered by health insurance, out-of-pocket costs can range from zero to more than $1,000, depending on deductibles, copay and coinsurance amounts. For example, a Medicare patient at Dartmouth-Hitchcock Medical Center would pay $1,477, including deductibles and coinsurance. However, some insurance plans, such as the Blue Cross Blue Shield of Michigan Community Blue PPO plan, cover "wellness" screenings 100 percent, with no deductible or copay, usually with some restrictions.
What should be included:
• During the procedure, the patient is sedated, then the doctor uses a flexible tube with a camera and light on it -- a colonoscope -- to examine the rectum and inside the full length of the colon.
• If anything suspicious is found, the doctor can take a sample for biopsy.
Additional costs:
• If polyps need to be removed during the procedure, the cost increases.
• A new procedure called "virtual colonoscopy," an X-ray test that checks for colon cancer, is available. However, it is more expensive and does not detect very small polyps as reliably as a conventional colonoscopy. It is not yet considered an equal alternative to the colonoscopy.
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