Cancer Treatment in a Plain Wrapper: Chemotherapy and “Brown Bagging”
One practice by insurance companies, in which these drugs are shipped directly to the patient or the pharmacy rather than the oncologist, threatens to disturb the fragile conditions under which these treatments work best. Oncologists have coined the term “brown bagging” to describe this practice, as many of these drugs arrive at the patient’s doorstep in plain brown shipping containers with no labeling, warning or protection. “Brown bagging” typically occurs when an insurance company employs a less-costly pharmaceutical wholesaler to supply the drugs. From there, the supplier will ship the drugs either to the patient’s local pharmacy or to the patient themselves. Once the patient receives the drugs, they carry them in the “brown bag” to their oncologist for treatment. At that point, the oncologist receives the drugs, must check that they are in ideal condition and, if they meet the requirements, take the extra time to prepare the infusion. In standard chemotherapy treatment, the oncologist has the drugs on hand and placed in containers that protect them from adverse environmental conditions. Before the patient comes in for an infusion, the oncologist has the proper drug “cocktail” prepared, thus saving the time of checking the ingredients, developing the mixture and setting up the treatment session. This procedure saves time for the doctor and spares the patient the anxiety and stress of making multiple trips and worrying about the drugs’ effectiveness. Unfortunately, the oncologist cannot tell if a chemotherapy drug has been altered until they prepare the infusion. Such uncertainty presents dangerous situations for patients even in the best of circumstances. The unknown variables introduced by “brown bagging” take the quality control issues out of the hands of the oncologist and put them in the hands of the untrained patients, pharmacists and couriers. As drug prices continue to rise , many patients stand to lose their health insurance benefits and will be unable to afford the medicines they need. Meanwhile, in efforts to cut their costs , insurance companies will continue with the practice of “brown bagging”, regardless of its potential risk to their customers. Many oncologists and nurses, recognizing the danger inherent in the method, have refused to deal with insurance companies who practice “brown bagging” of chemotherapy drugs. Until this impasse is resolved, doctors stand to lose patients who need vital treatments and insurance companies may lose customers who can’t afford the premiums. However, the players in this game with the biggest stake are also the ones that can’t afford to lose: the patients themselves.
More on brown bagging of chemotherapy drugs.
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The
use of chemotherapy in patients with advanced malignant pleural mesothelioma:
a clinical practice guideline.
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