Cost Concerns of Patients With Cancer

Stump, Tammy K.; Eghan, Naa; Egleston, Brian L.; Hamilton, Olivia; Pirollo, Melanie; Schwartz, J. Sanford; Armstrong, Katrina; Beck, Jürgen; Meropol, Neal J.; Wong, Yu Ning

doi:10.1200/jop.2013.000929

Cited by 73 publications

(57 citation statements)

References 16 publications

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“…Out-of-pocket costs and financial concerns may be substantial even when the survivors have health insurance coverage [9, 19–21]. Across diverse studies, more than one third of survivors report concerns paying for medical care, financial hardship, or having had financial problems related to cancer [19, 21, 22]. Moreover, concerns are not unique to survivors in the United States.…”

Section: Discussionmentioning

confidence: 99%

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Pisu

Martin

Shewchuk

et al. 2014

Support Care Cancer

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Purpose Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care. Methods In this pilot study, three Nominal Group Technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses. Results The most relevant responses addressed the: (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients, and consider costs in their treatment plans. Conclusions Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.

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Section: Discussionmentioning

confidence: 99%

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Pisu

Martin

Shewchuk

et al. 2014

Support Care Cancer

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“…This means that the cost of treatment can become a major factor in decision making for cancer patients. 10 Many patients will forego high-cost treatments altogether, or discontinue them early if the expense becomes prohibitive. 11 A recent survey of medical oncologists from the USA indicated that the vast majority felt obliged to offer all available treatment options to their patients regardless of their cost.…”

Section: What Does This Study Add?mentioning

confidence: 99%

Discussing and prescribing expensive unfunded anticancer drugs in Australia

et al. 2017

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ObjectiveAustralia has a publicly funded universal healthcare system which heavily subsidises the cost of most registered anticancer drugs. The use of anticancer drugs that are unfunded, that is, not subsidised by the government, entails substantial out-of-pocket costs for patients. We sought to determine how frequently Australian medical oncologists discuss and prescribe unfunded anticancer drugs, and their attitudes and beliefs about their use.MethodsMembers of the Medical Oncology Group of Australia (MOGA) completed an online survey about their clinical practices over a recent 3-month period. A negative binomial regression model was used to examine the influence of respondent characteristics on the rate of discussions about, and prescription of, unfunded anticancer drugs.ResultsOf the 154 respondents (27% of 575 MOGA members), 92% had discussed and 68% had prescribed at least one unfunded anticancer drug in the last 3 months. Respondents reported discussing unfunded anticancer drugs with an average of 2.5 patients per month (95% CI 2.1 to 2.9), and prescribed them to an average of 0.9 patients per month (95% CI 0.7 to 1.2). The rate of discussing unfunded anticancer drugs was associated with being fully qualified (p=0.01), and being in a metropolitan practice (p=0.009), the rate of prescription was associated only with being in metropolitan practice (p=0.006). The concerns about discussing and prescribing unfunded anticancer drugs rated most important were as follows: ‘potential to cause financial hardship’ and ‘difficulty for patients to evaluate the benefits versus the costs’.ConclusionsAustralian medical oncologists frequently discuss and prescribe unfunded anticancer drugs, and are concerned about their patients having to face difficult decisions and financial hardship. Further research is needed to better understand the factors that affect how oncologists and patients value expensive, unfunded anticancer drugs.

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“…8 Conversely, patients who are appropriately enrolled in hospice care report better symptom management and have a greater likelihood of dying in their preferred place 9 and with lower overall costs. 17 By 2015, close to one-half of Medicare decedents received hospice services. 13,14 Place of death last was examined comprehensively in 2004, when simple trend data from 1980 through 1998 demonstrated a decrease in hospital deaths and an increase in home deaths, the majority noted among the population of patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities

Chino

Kamal

LeBlanc

et al. 2018

Cancer

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BACKGROUND Place of death is an essential component of high quality cancer care and comprehensive national trends and disparities in place of death are unknown. METHODS Deidentified death certificate data were obtained via the National Center for Health Statistics. All cancer deaths from 1999 through 2015 were included. Multivariate logistic regression was used to test for disparities in place of death associated with sociodemographic variables. RESULTS From 1999 through 2015, a total of 9,646,498 cancer deaths occurred. Hospital deaths decreased (from 36.6% to 24.6%), whereas the rate of home deaths (38.4% to 42.6%) and hospice facility deaths (0% to 14.0%) both increased (all P<.001). On multivariate logistic regression, all assessed variables were found to be associated with place of death. Specifically, younger age (age birth‐14 years: odds ratio [OR], 2.39; age 25‐44 years: OR, 1.62), black (OR, 1.83) or Asian (OR, 1.74) race, and Hispanic ethnicity (OR, 1.41) were associated with hospital death. Being married (OR, 2.17) or widowed (OR, 1.56) was associated with home death whereas increasing educational level (OR, 1.15‐1.19) was associated with hospice death (all P<.001). Despite overall improvements, certain disparities were found to increase. For young patients, the likelihood of a hospital death increased from 2.3 times to 3.4 times that of older patients (50.9% for those aged 15‐24 years vs 15.0% for those aged ≥85 years in 2015). For black patients, the likelihood of a hospital death increased from 1.29 times to 1.42 times that of white patients (32.8% for black patients vs 23.1% for white patients in 2015). CONCLUSIONS Hospital cancer deaths decreased by approximately one‐third with commensurate increases in home and hospice facility deaths. Many sociodemographic groups experience significant disparities with regard to place of death and may benefit from targeted efforts to improve goal‐concordant care.

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Cost Concerns of Patients With Cancer

Cited by 73 publications

References 16 publications

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Discussing and prescribing expensive unfunded anticancer drugs in Australia

Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities

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