Abstract IA10: Financial distress in patients with cancer: Contributing factors and potential solutions

As the cost of cancer care in the United States continues to rise at an unprecedented rate, cancer patients are struggling to pay their share of the bill. Along with other measures of financial distress, cancer patients are 2.65 times more likely to file for bankruptcy than patients without cancer. Several recent reports suggest that individuals who face such financial challenges during treatment are more likely to report treatment non-adherence, poorer quality of life, and may suffer worse clinical outcomes. Despite an increasing awareness of “financial toxicity” among cancer patients, few oncology practices have processes in place to identify high out-of-pocket spending for cancer care and to provide assistance to patients struggling to pay for treatment or manage other life expenses. Given the rising cost of cancer care and its growing impact on cancer patients' financial health, the oncology community must be proactive in developing tools to steer vulnerable patients towards appropriate resources to reduce or prevent financial crisis. Such an approach may help to reduce disparities in treatment, adherence, and outcomes faced by cancer patients with limited financial reserves.

Addressing the patient-level financial burden of cancer care requires a multifaceted approach, including efforts at the policy level to negotiate pharmaceutical drug prices and improve structure of existing health insurance plans (e.g. Patient Protection and Affordable Care Act). At the health system and payer level, efforts to improve cost transparency may decrease waste and price variation while improving care quality.

At the patient and provider level, we propose several solutions that may also help to mitigate the financial burden of cancer treatment: 1) develop tools to track patient out-of-pocket costs and level of financial distress in real time; 2) develop strategies to align patients with available financial assistance resources from the time of diagnosis; 3) improve transparency about available effective treatment options and associated out-of-pocket costs to improve shared decision-making. In the era of widespread mobile phone and smartphone use across all racial and income groups, leveraging mobile technology to accomplish some of these goals is particularly appealing.

Citation Format: Veena Shankaran. Financial distress in patients with cancer: Contributing factors and potential solutions. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr IA10.