For 65 years, CancerCare in New York has been devoted to helping cancer patients, survivors, and their families. The group offers a full menu of services, from free telephone conferences to web chats with social workers. Last year, CancerCare introduced a foundation to help patients with drug co-pays. The $15 million co-pay assistance foundation is “going well,” executive director Diane Blum says, and covers six different cancer diagnoses.
In our telephone interview, Blum discussed a wide range of issues that affect cancer patients and survivors. She notes that there is good news – more people are living long lives after diagnosis and treatment. But that has created a host of post-treatment issues that require support.
Blum, who became executive director of CancerCare in 1990, has an extensive background in social service work. She served as a social work supervisor at Memorial Sloan Kettering Cancer Center in New York City and the Dana-Farber Cancer Institute in Boston. She is co-founder of the National Alliance of Breast Cancer Organizations and editor-in-chief of cancer.net, the ASCO website for patients and the public.
Here is a Q&A with Blum. I will post half today and half tomorrow.
Q. I’m interested in the work CancerCare is doing on its financial assistance program. What prompted it, and how long it has been going on?
A. It has been going on a very long time. CancerCare was founded 65 years ago, with a dual mission, and that was to provide counseling to families who were caring for someone who at that point was dying from cancer. The mission was just focused on people with end of life issues and also to provide financial assistance to those families.
So over the 65 years, that mission has been expanded to include people at all stages of diagnosis so we help people from new diagnosis now through end of life care as well as bereavement for their caregivers.
But financial assistance has been maintained as an integral part of what we do. We have a long, long track record of being able to provide money to people to meet unmet needs.
Q. Has that need expanded recently?
A. Yes, I mean there has always been a need, we have never had enough money, it is an infinite problem and we’re a private organization offering a service when many people would benefit of a more societal approach to problems than we’re able to offer, but we’re very committed to it for a whole variety of reasons. But we certainly have seen an increase, probably I would say since last summer, in the last 7 or 8 months, we saw a big increase in financial need last summer with the enormous jump in gas prices, because a lot of people come to us for help with their transportation costs to get to treatment. That diminished a bit as the price of oil came down, but it has been more than replaced by the economic crisis, which results in more people being unemployed, more people who no longer have health insurance, more people who are working but either can’t pay the premiums that their employer requires or their employer no longer offers health insurance because the cost has become prohibitive for the employer.
And just the decrease in discretionary income that people feel because there has been this stress on everything. Whether you’re out of work or whether your savings have decreased, or you’re worried about paying your mortgage or whether you’re living on a fixed income and the cost of food has gone up for you. I could go on and on and on. But it’s across the board. So because we very much live in the real world, we hear all of that now.
Q. Let’s take a hypothetical. How would you provide help for a patient with drug costs? In cancer, there are drugs that are super-specialized and very expensive.
A. We actually a year ago established a co-pay assistance foundation. We did that because we had the six decades of experience of providing financial assistance and we were hearing from more and more people who could not afford the co-pay that their expensive cancer drug required. And co-pays are the result of more insurance companies moving these specialty drugs into a separate tier. Where you might typically have a $25 or $50 co-pay, with these specialty drugs the co-pay is a fixed amount but is a percentage of the drugs. So we established a co-pay foundation last spring. We’re just about to finish a year with it.
Q. How is the program going?
A. It is actually going very well, it is a complement to our traditional services and it is meeting a real need. There we give people larger amounts of money because drugs are so expensive. You can meet a transportation need with a smaller amount of money. The need for a drug that costs $8,000 a month is harder to meet with a smaller amount of money.
We cover at the moment six different diagnoses: lung, colon, breast, prostate, head and neck and pancreas.
So if you have problems with a co-pay for any drug you’re getting for breast cancer, we can help you.
At this point we’re not providing funding for any of the blood cancers, which we would like to do at some point. And we also are not providing funding for gynecological cancers, which actually don’t have a whole lot of expensive drugs attached to them.
We’re very pleased that we made the decision to do this. It is meeting a need. But health care is in such incredible turmoil, and under the spotlight. We are a private organization operating CancerCare on a $20 million budget and the co-pay foundation on about a $15 million budget. So we’re a reasonable size with the two organizations put together, but again these are societal problems that we can’t solve alone.
TOMORROW: Post-treatment needs, and health care reform.