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Coping with the Cost of Cancer Care: Q and A with James T. Martin, Ph.D.

On Tuesday, March 25, the Cancer Support Community Valley/Ventura/Santa Barbara will present “Frankly Speaking: Coping with the Cost of Care.”  Moderator James T. Martin has a Ph.D. in economics and has worked in both the financial services sector and healthcare industry.

JamesMartin3

Photo by Judi Bumstead

Dr. Martin has over 23 years in the pharmaceutical and health care industry in a variety of roles evaluating healthcare policy and working with both providers and hospitals and other facilities.  In previous roles, he was President of two foundations providing free pharmaceuticals to indigent and under-insured patients, he has managed the SOX process for Pricing and Contracting, and he has worked closely with government affairs evaluating healthcare policy.  He currently is Treasurer of the CSCVVSB Board of Directors and attends a caregiver support group.  In the past year, he cared for his mother who was stricken with several cancers and succumbed to the disease in October 2013.  Dr. Martin occasionally consults through 1798 Consultants, Inc. on a variety of pharmaceutical products and policy issues.

In advance of his March 25 workshop, Dr. Martin was kind enough to answer our questions about coping with the cost of care.

CSCVVSB:  First, thank you for taking the time for the interview and for presenting on the cost of cancer care.  In your perspective, what are the primary challenges in the healthcare system regarding oncology treatments?

JM:  You’re welcome.  It is my pleasure to be here and share my experience.  In terms of oncology care, the Institute of Medicine (IOM) just published a wonderful article on cancer care and what cancer patients will face in the coming decade.  It makes the case that cancer care in the U.S. is facing a major crisis caused by three factors.  First, as the population ages, more cancer cases will occur.  And we now find that cancer patients are living longer and requiring significantly more treatment over time.  Secondly, cancer care in the U.S. was always expensive but is getting prohibitively expensive.  Lastly, our society must develop improved methods for reimbursing cancer care and deciding what care warrants an additional expenditure.  So, in summary, more patients having cancer, more patients living longer which is a testament to better care;  however, these patients are using much more expensive resources.  Lastly, our society has had an inability to rationally adjust how we pay for cancer care yet we must address this issue or it will overwhelm healthcare.

CSCVVSB:   Wow!  That is a lot to comprehend.  Perhaps we can talk more about cancer patients today.  If your mother had just been diagnosed with cancer, what would you recommend?

JM:  Good question.  There are many aspects to care starting with insurance, financial resources, pharmaceutical resources, nutrition support, psychosocial support, and spiritual support.   First, I would want to evaluate her insurance.  Cancer Support Community National has worked with other industry groups to create a template that every cancer patient or caregiver should fill out.  It is called the cancer insurance checklist and can be found at: www.cancerinsurancechecklist.org.

CSCVVSB:  Is that all?

JM:   Well, I was just getting started.  Once a patient understands their care and their insurance costs, they likely can see where they may require assistance.  Even during this stressful time, cancer patients must be aware that cancer care can negatively impact their family’s credit rating or even force them toward bankruptcy.  Now is the time to truly be prudent and assess all options for assistance.

There are many organizations that provide copayment support.  This can be through a pharmaceutical company sponsored organization or through an independent foundation. A patient may also receive free drugs if they qualify for special programs.  There is a CMS sponsored clearing house found at PPARX.com.

CSCVVSB:  What next?

JM:  Here is where I turn to the resources offered by CSCVVSB.  They offer wonderful psychosocial support programs including nutrition programs; counseling for patient, caregiver, and children; stress relief programs such as yoga, Tai Chi and Qi Gong.  It is great that the National Institute of Health has demonstrated that psychosocial support provided by the Cancer Support Community actually helps a cancer patient achieve significantly better outcomes.

CSCVVSB:  Anything else?

JM:  Cancer is a journey.  One needs to start the journey by assessing all of one’s needs.  Whether it is the cancer patient or the caregiver, someone must take the role of the quarterback to assess all information and choose a reasonable course for the patient.  As difficult as it is, insurance, care options, financial resources, and other psychosocial support resources must be evaluated.   One must become educated in all aspects of care and support.  Although it is very difficult, it is necessary in today’s world for oncology care.  Start the process by participating at CSCVVSB (or a Cancer Support Community near you).

CSCVVSB:  Thank you for your time today!

JM:  You’re very welcome.  I am glad to be of assistance.

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