2023 Grantee: Arjun Gupta, MD
University of Minnesota Medical School
Research Project: Medication-related Financial Burdens in Older Adults with Pancreatic Cancer
Award: 2023 Pancreatic Cancer Action Network Career Development Award
Award Period: July 1, 2023 – June 30, 2025
Dr. Arjun Gupta is an Assistant Professor in the Division of Hematology, Oncology, and Transplantation at the University of Minnesota Medical School. He completed medical school at the All India Institute of Medical Sciences, New Delhi, Internal Medicine residency and chief residency at UT Southwestern Medical Center in Dallas and Medical Oncology fellowship and chief fellowship at Johns Hopkins University in Baltimore.
He is a gastrointestinal medical oncologist with a focus on treating persons with pancreatic cancer, a symptom management enthusiast, and a health services researcher. He serves as the Vice Chair of the Symptom Intervention Committee of ALLIANCE and is a member of the ASCO Gastrointestinal Cancer and Supportive Care Guideline Advisory Groups. His research specifically examines cancer care access and delivery, the costs of cancer care, and the hidden burdens imposed on and faced by people with cancer and their caregivers. His team has recently conceptualized “time toxicity,” the time burdens of receiving cancer care. Much of his current work focuses on describing, measuring, and addressing these time burdens in clinical trials and in clinical practice.
Pancreatic cancer and its treatment can cause patients to experience burdensome symptoms like pain, nausea, and nerve damage, and some even develop serious complications such as diabetes and blood clots. Patients often require supportive care medications to manage these symptoms and complications. The use of these medications is even more common and important in older adults with pancreatic cancer, who are more prone to side effects.
Though supportive care medications are important for patients with pancreatic cancer, many are extremely costly. For example, the out-of-pocket costs for a single month’s supply of pancreatic enzymes – a key medication often used by patients with pancreatic cancer to aid in digestion – is $1,000. High costs force many patients into not taking medications or taking lesser than prescribed amount of medications. Even among patients using only lower-cost medications, the cumulative financial burdens in paying for multiple medications and refills over the disease course can be substantial.
The objective of Dr. Gupta’s project is to understand the financial burdens of medications among older adults with pancreatic cancer using mixed (qualitative and quantitative) methods. Dr. Gupta has assembled a multidisciplinary team for this effort, including a patient advocate, qualitative methodologists, health services researchers, health policy experts, and oncologists. They will (1) conduct qualitative interviews with patients, caregivers and clinicians to explore their perspectives on and experiences with medication costs, and (2) analyze national-level patterns of use of medications and their associated costs. The team’s central hypothesis is that out-of-pocket costs of supportive care medications will be higher than that of cancer treatment for patients with pancreatic cancer, and a source of significant anxiety and distress. In related work, Dr. Gupta and his team are also evaluating the time-related burdens of cancer care faced by people affected by pancreatic cancer.
This work will improve pancreatic cancer care by supporting advocacy efforts to reduce drug prices, informing policy efforts to re-design insurance coverage of medications, and identifying medication misuse (overuse and underuse) to optimize prescribing.