Androgen deprivation therapy (ADT), also called hormone therapy, is a common treatment for metastatic prostate cancer. It works by starving the cancer of testosterone, which fuels the tumor’s growth.
There are two forms of ADT: Surgical castration is done with a procedure, and medical castration requires ongoing ADT treatment — usually for life. While medical castration is more common, it can also be costly, especially for those who are uninsured or underinsured.
To answer your questions about the cost of ADT treatment, we spoke to Adam Weiner, MD, a urologic oncologist at Cedars-Sinai in Los Angeles. Here, he breaks down the financial aspect of treatment and offers advice on how to find help paying for it.
Editor’s note: This interview has been edited for length and clarity.
Everyday Health: How much does ADT cost?
However, individual out-of-pocket costs vary based on your health insurance, including which medications your plan covers and to what extent.
The most common form of ADT — and the most commonly covered form of ADT — is a depo shot, usually leuprolide, which is an injection of hormones that essentially turn off the production of testosterone in the testicles. Leuprolide (an LHRH [hormone] agonist) is usually covered by insurance, whereas the oral medication relugolix (Orgovyx) isn’t covered as often.
EH: Will I need to take other treatments besides ADT, and will that increase the cost?
AW: Possibly. If you have metastatic prostate cancer that’s pressing into the spinal cord, for example, you may need more urgent treatment, such as radiation. And, depending on your insurance coverage, additional treatments can increase out-of-pocket costs.
Some people may also need to take another medication called an LHRH antagonist, which works quickly to prevent the testosterone surge that can sometimes occur when you take LHRH agonists. Oftentimes, these antagonists aren’t covered by insurance, so they end up being an out-of-pocket expense.
EH: Will I make monthly payments?
AW: It depends on the type of ADT you take.
ADT injections, for example, need to be administered by a doctor every one, three, or six months. So you may need to pay for the medication, as well as the fee for the appointment, anywhere from 2 to 12 times each year. Most commonly, though, people get injections every three months, amounting to four payments per year. And the exact monthly costs can vary based on your insurance coverage.
Oral medications are taken daily, and prescriptions may need to be filled every one to three months. In some cases, getting three months at a time can be cheaper than refilling monthly, depending on your prescription benefits.
EH: Could taking a break from ADT help lower treatment costs?
AW: Intermittent ADT — meaning, taking a temporary break from hormone therapy before restarting — is a viable treatment strategy for some people. However, it’s not a decision that should be made for cost-saving purposes. Rather, it’s used to alleviate some of the side effects from ADT, such as hot flashes or low libido.
EH: If ADT is too expensive, are there other treatments I can try instead?
EH: Are there any programs that can help me cover the cost of ADT?
AW: Yes. Nonprofit organizations and patient assistance programs are available to help cover the cost of some forms of ADT. Here are some to check out:
These programs offer financial assistance to help cover expenses such as deductibles, copays, and out-of-pocket treatment costs.
Some pharmaceutical companies also offer patient assistance programs, which can help people with commercial insurance pay a small fee for their medication.
EH: Can a financial counselor or social worker help me find more cost-saving resources?
AW: Definitely. You can often find this kind of help at your oncology center. A financial counselor or social worker can help you find ways to pay for ADT plus any other advanced prostate cancer treatment you may be getting.
The Takeaway
- The cost of androgen deprivation therapy (ADT) can depend on your individual health insurance plan and which form of ADT you’ve been prescribed.
- You may also need other treatments for metastatic prostate cancer, such as radiation, which can further add to care costs.
- You can find additional financial assistance through a social worker at the oncology center you go to or various nonprofit organizations that help cover treatment costs.
