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Patients often change lifestyle, medical care due to cancer costs
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The financial burden of cancer care often prompted insured patients to alter their lifestyle and their medical care strategies, according to survey results presented at the Palliative Care in Oncology Symposium.
“We found in previous studies that financial burden due to cancer care does cause substantial distress for patients,” researcher Ryan Nipp, MD, oncology fellow at Dana-Farber Cancer Institute, said during a press conference. “We’ve also shown in prior studies that patients adopt different strategies to cope with the financial burden of their care. With this study, we have aimed to describe how patients cope with treatment-related costs, and we also wanted to determine which patients may be at risk for certain cost-saving strategies.”
Nipp and colleagues conducted a nationwide survey that included 174 patients (median age, 67 years) who were insured but who had requested financial assistance from a national copay assistance program.
The majority of patients were non-Hispanic white (83%) and female (96%).
Most patients had breast cancer (85%), whereas 4% had colorectal cancer and 11% had another solid tumor.
Results indicated 89% of patients made lifestyle alterations in order to deal with treatment costs. Common strategies included spending less on leisure activities (78%), spending less on basic essentials such as food and clothing (57%), borrowing money (54%) and spending their savings (50%). Eighteen percent of patients reported selling possessions and 15% had family members who worked more in order to help with the patient’s medical costs.
Thirty-nine percent of patients tried to cope with their treatment-related financial burden by making adjustments to their medical care. Common strategies included not filling a prescription (28%) and taking less medication than prescribed (23%). Other patients reported missing a test (10%), missing a procedure (8%) or missing an appointment (6%) to try to reduce costs.
Patients aged younger than 65 years used more care-altering (1.2 vs. 0.4; P˂.01) and lifestyle-altering (3.9 vs. 2.4; P˂.01) strategies than those aged 65 years or older.
Care-altering strategies were more common among patients with an income less than $20,000 compared with those who had higher incomes (0.9 vs. 0.6; P=.02). Lifestyle alterations were more common among patients who had more than a high school education (3.4 vs. 2.7; P=.02) and those who were received chemotherapy for less than 1 year (3.5 vs. 2.8; P=.04).
“We need a better, more open dialogue between patients and providers about the financial burden associated with cancer care costs,” Nipp said in a press release. “We found that people use a range of different cost-coping strategies, and we need to engage with patients on their choices and develop screening tools to identify patients who are likely to make potentially harming decisions about their treatment.”
For more information:
Nipp RD. Abstract #161. Scheduled for presentation at: Palliative Care in Oncology Symposium; Oct. 24-25, 2014; Boston.
Disclosure: The study was funded by HealthWell Foundation.
Perspective
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Jyoti D. Patel, MD
As we make strides into understanding the whole patient, it is absolutely incumbent upon us to have conversations to understand the financial pressures that patients face, and the implications of those pressures. If up to 40% of patients are jeopardizing or altering their treatment, we have to have very guided efforts to support these patients during these times.
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