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Cancer Patients Want More Information From Doctors About Cost

A study led by researchers from University of Michigan has found that many cancer patients would like more help from their health care providers in addressing costs of treatment. The study involved more than 3,000 people who answered a survey, including 2,502 women with early-stage breast cancer, 370 surgeons, 306 medical oncologists, and 169 radiation oncologists. The study was published online July 23, 2018 in Cancer, a peer-reviewed journal published by the American Cancer Society.

Cancer takes a financial toll on many patients, even if they have health insurance, due to out-of-pocket costs and copays for treatment and other medications, and sometimes due to loss of work hours or gaps in employment. Previous studies have shown people with cancer have an increased rate of bankruptcy filings. Financial problems are linked to higher overall distress, lower health-related quality of life, and lower satisfaction with cancer care.

To find participants for the current study, researchers searched the Surveillance, Epidemiology, and End Results (SEER) database provided by the National Cancer Institute (NCI). Questionnaires for the participants’ health care providers asked how often they discuss the financial burden of treatment with their patients, their level of awareness of the out-of-pocket costs of tests and treatments they recommend, and how important they think it is to try to save their patients money. Questionnaires for patients asked about financial and employment status changes since being diagnosed, how much cost-related help they received from their health care team, and whether they continue to have unmet financial needs. Researchers also evaluated whether age, race, and ethnicity played a factor.

Results showed providers and patients have different perceptions about how often these financial discussions are taking place.

Among the findings: providers
50.9% of medical oncologists, 43.2% of radiation oncologists, and 15.6% of surgeons said that someone in their practice often or always discusses finances with patients.
40% of medical oncologists, 34.3% of radiation oncologists, and 27.3% of surgeons said they were very aware or quite aware of the out-of-pocket costs of the tests and treatments they recommend.
57% of medical oncologists, 55.8% of radiation oncologists, and 35.3% of surgeons said it was quite important or extremely important to save their patients money.

Among the findings: patients
58.9% of black patients, 33.5% of Latina patients, 28.8% of Asian patients, and 27.1% of white patients reported having debt from treatment costs.
Overall, 14% of patients reported lost income that totaled 10% or more of their household income.
Overall, 17% of patients reported spending 10% or more of their household income on out-of-pocket medical expenses.
45.2% of black patients, 35.8% of Latina patients, 22.5% of Asian patients, and 21.5% of white patients reported cutting back on food spending to pay for cancer treatment. Some