The cost of chemotherapy can vary depending on a variety of factors, such as whether a person has health insurance, the type and severity of their cancer, and whether a person requires additional treatment.
Chemotherapy is a common cancer treatment that doctors may use as part of a larger treatment plan.
The costs of chemotherapy can vary widely based on the kind of chemotherapy a person receives and their health insurance plan.
This article looks at the typical costs of chemotherapy and how the cost varies depending on the type of cancer and whether a person has health insurance or not. It also looks at additional costs to consider during cancer treatment.
The average costs of chemotherapy are highly variable, and many factors can influence how much a person may need to pay.
One 2016 study found the average total cost of a 6-month course of chemotherapy to be almost $27,000.
However, according to the American Cancer Society (ACS), the already high costs of cancer treatments are rising. They predict a 34% increase in the costs of cancer-related care by 2030.
Medicare does provide coverage for chemotherapy. However, a person may have to pay up to 20% of the costs of the treatment out-of-pocket, depending on the type of health insurance they have.
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Research from 2019 found that the average out-of-pocket costs of chemotherapy under Medicare Part D varied depending on the type of medication doctors prescribed. In some cases, the cost could exceed $8,000.
What factors can affect the cost of chemotherapy?
Several factors can influence the cost of chemotherapy. These include:
- Health insurance: Whether a person has health insurance and the type of insurance coverage a person has can have a major impact on the costs of their treatment.
- Type of chemotherapy: A team of healthcare professionals will put together a treatment plan based on the type and severity of a person’s cancer and other factors, such as their age and overall health. Certain chemotherapy drugs and methods of administration may be more costly than others. A study from 2017 shows that common oral chemotherapies cost between
$7,500 and $25,000 monthly for Medicare patients. - Length of treatment: Some people may require longer or more frequent cycles of chemotherapy, depending on the type and severity of cancer they have and how they respond to treatment.
- Treatment setting: Where a person receives treatment, such as in a hospital, home setting, or an office or clinic, may influence the cost of the treatment and the amount that insurance will cover.
- Other treatment: A person may require other medications to treat the side effects of chemotherapy, such as pain, nausea, diarrhea, and anxiety.
- Geographic location: Areas that have higher costs of living typically have higher treatment costs.
The costs of chemotherapy may include more than the chemotherapy drugs. Other chemotherapy expenses can include:
- imaging tests, such as MRI or CT scans, to monitor a person’s progress
- office, clinic, or treatment visits
- consultations with specialists
- laboratory tests
- additional medications to treat chemotherapy side effects
A person may also encounter costs that are not directly a part of chemotherapy treatment. These can include:
- transportation costs, which may include transportation to treatment and parking fees for hospitals or clinics
- mental health costs, such as fees for medication, counseling, or psychotherapy
- accommodation, as some people require lodging closer to treatment centers
- home care, such as medications, equipment, and home visits from healthcare professionals
- rehabilitation costs, such as physical therapy
- home assistance, such as help with cleaning, shopping, cooking, or child care
- over-the-counter medications to assist with side effects and symptoms
The type of cancer a person has can affect the cost of chemotherapy.
Research from 2019 found that under Medicare Part D, out-of-pocket chemotherapy costs for specific chemotherapies is based on the type of cancer:
| Cancer | Cost |
|---|---|
| Prostate cancer | $8,181–$8,586 |
| Leukemia | $8,712–$16,551 |
| Breast cancer | $8,842–$12,145 |
| Lymphoma | $10,175 |
| Ovarian cancer | $10,386–$11,625 |
| Lung cancer | $11,014 |
| Multiple myeloma | $14,461 |
The differences in the costs of treatment for specific cancers varied significantly according to the types of drugs doctors prescribed.
For example, leukemia treatment with Venclexta (venetoclax) cost an average out-of-pocket amount of $8,712, while leukemia treatment with Idhifa (enasidenib) cost $16,551.
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A person can speak with their insurance provider to find out how they can help cover the cost of chemotherapy.
Medicare
Medicare is the health insurance program for people ages 65 and older in the United States, although some younger people may qualify.
Medicare covers chemotherapy and other cancer treatments.
How and in what setting a person receives chemotherapy can determine which parts of Medicare coverage apply and which out-of-pocket expenses a person will have to cover. Medicare parts include:
- Part A: This part of Medicare covers in-hospital care.
- Part B: This covers outpatient services such as doctor visits, medical equipment, and preventive care.
- Part D: This covers a variety of prescription medications.
In many cases, a person will need to pay some out-of-pocket costs. To keep track of potential mounting costs, a person can:
- Learn the terms of their insurance policy.
- Maintain careful records of costs.
- Be aware of which preferred or network hospitals, doctors, and clinics apply to the policy.
- Plan for out-of-network costs in advance.
The federal government website can help a person choose the right Medicare option and sign up.
For people without insurance, the costs of chemotherapy and other cancer treatments can be overwhelming.
A person should discuss the costs of treatment with their doctor or healthcare professional, who can refer them to a social worker or navigator to assist with finances and resources.
Various organizations provide financial help and information on how to manage the costs of chemotherapy and other costs of cancer. These include:
ACS - CancerCare
- American Society of Clinical Oncology (ASCO)
- Pharmaceutical Research and Manufacturers of America (PhRMA) provides a Medicine Assistance Tool (MAT) that a person can use to find financial assistance resources for prescription medications.
A person may also find cancer medications through organizations such as RemidiChain. This is an organization that accepts donations of cancer medications that are unopened and unexpired. It can match these medications to those who may not be able to afford their cancer medication.
Medicaid
Medicaid is a state-run program that helps people with limited incomes.
It can help pay for healthcare costs such as medications, doctor visits, and hospital visits. In some states, the program may have a different name.
To find the correct program, a person can visit the US Department of Health and Human Services to find their State Health Department.
There are various potential additional costs of cancer treatment. These can include:
- prescription medications
- office and clinic visits and treatments
- specialist referrals
- laboratory tests, such as blood and urine tests
- procedures for treatment and diagnosis
- surgeries
- imaging tests
- hospital stays
- radiation therapy, or other therapies such as immunotherapy
- rehabilitation
- transportation
- accommodation
- home care
- loss of earnings
- child or elderly care
- urgent care or emergency room visits if needed
Worrying about the financial aspect of receiving chemotherapy can be overwhelming. If a person is finding it challenging to pay the expenses, this worry and stress
If people are experiencing stress as a result of paying for cancer treatment, they should reach out to their healthcare team for support and help coping with this distress.
The cost of chemotherapy varies depending on a variety of factors. These include whether a person has health insurance and what kind, the type and severity of the cancer, the type of chemotherapy drugs a doctor prescribes, and where the treatment takes place.
Health insurance can help by partially covering the cost of treatment. However, a person may still need to pay out-of-pocket expenses.
The cost of chemotherapy can be overwhelming, especially for people without health insurance. A person should discuss the costs of their treatment with their healthcare team or health insurance providers to help them navigate the costs of treatment.
For further assistance, a person can discuss their financial situation with an assistance program or social worker.