- With Mayo Clinic nurse educator
Sheryl M. Ness, R.N.
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Sheryl M. Ness, R.N.
Sheryl M. Ness
Sheryl Ness, R.N., O.C.N., is a nurse educator for the Cancer Education Program at Mayo Clinic in Rochester, Minn. She helps inform patients, families and caregivers about services and resources to help them through the cancer journey.
She has a master's degree in nursing from Augsburg College. In addition, she is an assistant professor of oncology at the College of Medicine, Mayo Clinic, and is certified as a specialist in oncology nursing. Sheryl has worked for more than 20 years at Mayo Clinic as an educator. She has a keen interest in the importance of the quality of life and concerns of people living with cancer.
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Living with cancer blog
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July 7, 2012
New cancer treatments create cost challenges
By Sheryl M. Ness, R.N.
New cancer treatment methods using oral chemotherapy drugs — sometimes called biological therapy or targeted therapy — are changing the way people with some cancers are being treated.
This new way of treating cancers can be effective and convenient as the drugs are in pill form, can be prescribed by your treatment team and then taken at home instead of having to travel to a cancer treatment center for a chemotherapy infusion.
However, this trend brings a new challenge, covering the costs of the drugs. Most health insurance plans cover oral medications through a pharmacy benefit which can mean that only part of the cost is covered (a percentage or co-pay).
The new drugs are expensive and can cost thousands of dollars a year for treatment. As health plans try to catch up with the new changes, some people are still left paying for the high cost of treatment.
Patient advocates organized through the International Myeloma Foundation got involved early on and formed the Patients Equal Access Coalition (PEAC) which encouraged states to pass oral oncology parity laws, which give patients more affordable access to this treatment option, which may be the best treatment option available.
However, if you're still struggling to cover the costs of this type of treatment, you may want to look for support from patient assistance organizations such as the Patient Access Network (PAN) Foundation.
Through this blog, I want to introduce you to Emily Acland from the PAN Foundation. PAN has provided hundreds of millions of dollars in financial assistance to more than 132,000 qualifying patients with chronic or life-threatening illnesses.
PAN provides financial assistance to patients who, although they have insurance, still can't cover the out-of-pocket medical costs of the breakthrough medical treatments they need.
Emily says, "To those helped, it seems almost too good to be true." PAN accommodates all insurance plans, including Medicare. Patients can receive as much as a year's worth of funding (anywhere from $1,500-10,000 depending on their diagnosis) to cover the costs of their medications and treatments, often with the option to renew that support when patients have exhausted their initial grant.
PAN's application and claims processes are seamless — with no complicated paperwork to fill out and no waiting to be reimbursed. PAN has established direct relationships with doctors and more than 30 specialty pharmacies that speed approvals, payments and dispensing for both providers and patients.
Don't compromise with your health care because of cost. Available funds, applicant qualifications, and an online application can be found on PAN's website at www.panfoundation.org.
If you're uninsured and looking for additional assistance with covering the costs of cancer medications, look at Needy Meds for additional resources at www.needymeds.org. Feel free to share comments regarding this topic on the blog.
Follow me on Twitter at @SherylNess1. Join the discussion at #livingwithcancer.
11 comments posted
May 11, 2013 10:43 p.m.
My sister is only 36 and she live in Algeria ,she have synovial sarcoma rare Cancer .stage 3. What I can do to bring here in USA before it to late . No body can imagine how people with cancer suffer in Algeria they ask them to bring the medication if they need chemo .go to youtube
- Ammi
January 10, 2013 5:54 p.m.
i have cancer,,lung,,bone,,i get chemo every 3 weeks,,plus zometa,,the zometa is brutall,sooo very painfull,,i almost want to give up,,anyhow,,i am on disability,,most of my stuff is paid fully,,what i want to know if anyone knows if there is any help out here ,,to help with my utility bills,,water,,electric,,gas,,thanks
- mike
December 5, 2012 1:38 p.m.
The gov. pays ALL costs for Vietnam vets who have cancer because of Agent Orange plus disability checks & pension to survivors.
- mary
August 20, 2012 10:30 a.m.
Nita, you may want to call CancerCare Co-Payment Assistance Foundation at 866-552-6729. It looks as if they cover co-payment costs for Xeloda. I wish you the very best as you continue your treatment.
- Sheryl
August 16, 2012 3:31 p.m.
I am presently taking Xeloda, 3 in the morning and 2 at night...on one week,off one week. This durg is helping and I need to have it available, but of course, I cannot afford the residual after Medicare payment. Where can I go to obtain help? Ihave breast cancer that has metastacided into the bone in my spine. I am terminal and having the medicine has been a blessing. I can only hope you may direct me to a site, etc. To all my fellow cancer survivors, I applaud you. If treating it can contain the beast, it is worth the side effects, though it doesn't seem so at the time. Thank you.
- Nita
August 9, 2012 1:28 p.m.
Having epilepsy for 73 years and paying large amounts for its continuing medicine changes and needs, since July of 2009 I'v had pancreatic cancer. I'm covered to December yet my Oncologist suggests Afinitor now. My health insurance will cover me with a co-pay of $2600.00 a month. I'm single, retired, no family and no assets "is it worth it to opt out of treatment at this point, as I'm doing fairly well and live one day at a time within my limitations?"
- Kay
July 26, 2012 6:11 a.m.
I am an ICU doctor my mother gets MBC TO Bone and liver with ER and PR both moderate positivity .WE STRARTED WITH 4 CYCLEs OF FEC combination as neoadjuvant but it was resistant to FEC so we started a new regimen of cisplatinum and taxotere every 21d what is your opinion about this new start and may you advice me if gem-taxol is better specially that the disease coarse is progressive .thanks for your help
- dr.Zidan
July 15, 2012 7:32 a.m.
Good morning Read this article with interest. Yes, the pills are expensive. I am on xeloda and the pills are $280.00 each. Given I take six a day that is a pretty hefty figure dollar wise. I guess I am lucky. Medicare pays for 80 percent and my supplement pays the balance. So far, I have not had to pay a penny for the medicine. Our local hospital will not bill medicare but there is a pharmacy here that does. He told me it needs to be billed under Medicare B special needs. My problem with this home therapy is I annot swallow pills . The hosp. pharmacist has me dissolving them in tepid water and then adding a bit of juice and I have to swallow the liquid. It is really difficult due to the bitter taste.Thejuice does not hel that much as I can only add two taablespoons of juice. I am grateful for every advancement that is being made in cancer research. Sinc I have been dealing with it for fifteen years now I have seen the improvements. Thank you for the information on assistance if needed I am certainly printing the info off for future if needed. Perhaps they will come up with a pill that could be crushed and put on applesauce etc. I receie scans again at the end of this cycle so I am praying for improvement....metases of beast cancer to the bone. If there is no improvement I will be making a repeat trip to Mayo.
- Anna
July 14, 2012 3:40 p.m.
Seems our scientists, medical professionals, and insurance companies need to get with the "plan". Adaptability and flexibility are learned and quality skills; you either cope in positive manner or mismanage. Another area listed in this newsletter but in relation was oral side effects from chemo, of which I experienced even after treatment "finalized". Experimenting with an increase of daily vegetables and fruits (via smoothies), I discovered adding parsley (organic, curly) just about 'cured' the dry mouth and sores (who'da thought a natural remedy). I went back to my team and they did not have this knowledge but said to continue if it worked for me. 2+ years out I am doing fine and continue to gain strength and stamina. If there were more research into after effects, it might assist the three areas (science, medical, insurance) in progression and overall more natural cures while limiting costs. *Please be sure to check with your doctor first so not to go against treatment meds. Best to everyone!
- Sherry
July 13, 2012 7:19 a.m.
bravomayo n usa
- anwar
July 12, 2012 6:32 p.m.
cost challenges a polite way of how the pharma boys make their money. if someone has cancer there is no real alternative. Oral chemo is simply taking a pill, unfortunately for this, pills like any other pill, is a systemic effect, in effects and side effects. Make it localize effect, now your doing something for the patient.
- roy
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11 comments posted