High Cancer Treatment Costs Force Patients to Compromise on Care

A recent national survey found that the financial burden of cancer treatment leads many patients to make potentially harmful medical care and lifestyle tradeoffs in order to pay for treatment.

Results from the survey, presented ahead of the Palliative Care in Oncology Symposium in Boston this week, found that 89% of the 174 patients surveyed used at least one lifestyle-altering strategy to cope with costs, such as borrowing money, while 39% altered the course of their care by taking less medication than prescribed or not filling prescriptions. The survey included 174 insured adult patients undergoing treatment for solid malignancies who had requested financial aid through a national copay assistance program.

“We need a better, more open dialog between patients and providers about the financial burden associated with cancer care costs,” said lead study author Ryan David Nipp, MD, an oncology fellow at Dana Farber Cancer Institute in Boston. “We need to engage with patients on their choices and develop screening tools to identify patients who are likely to make potentially harmful decisions about their treatment.”

Patients who were younger (< 65) or those with lower-incomes were more likely than other respondents to alter their medical care, the survey found. Patients with more education and shorter duration of chemotherapy were more likely to adopt lifestyle-altering strategies, which also included spending less on leisure activities and basic necessities, and depleting their savings.

According to the American Cancer Society, 13% of cancer patients struggle with high out-of-pocket costs and about 20% spend their life savings on paying for treatment. This study is the first to explore sociodemographic factors associated with how patients cope with those pressures.

In a related study presented during the symposium, researchers reported that many cancer survivors experience financial or work-related hardship years after treatment. In the survey of 1,600 cancer survivors, 27% reported at least one financial problem, such as debt or bankruptcy, while 37% reported changing work plans, such as taking extended time off or delaying retirement.

The study found the greatest work and financial disparities among women and younger survivors as well as racial or ethnic minorities. The authors said the findings point to the urgent need for screening and support for financial and work challenges extending from diagnosis to long-term survivorship.

More than 200 studies were presented at the symposium, with topics ranging from symptom management, end-of-life care, and survivorship to early integration of palliative care and psycho-oncology. The event was co-sponsored by the American Society of Clinical Oncology (ASCO), the American Academy of Hospice and Palliative Medicine, the American Society for Radiation Oncology, and the Multinational Association of Supportive Care in Cancer.

ASCO’s Cancer.net, offers resources for patients coping with financial pressures, including a list of financial assistance programs, tips on how to discuss cost with providers, and help understanding what’s covered under different types of private and government-sponsored insurance plans.