Childhood cancer survivors spend more on out-of-pocket medical costs than siblings

Adult survivors of childhood cancer spent larger portions of their income on out-of-pocket medical costs than their siblings without cancer histories, study data showed.

“Survivors who reported spending a higher percentage of their income on out-of-pocket medical costs were not only more likely to report financial burden, they also were at risk for undertaking behaviors potentially detrimental to their health in order to save money,” Ryan Nipp, MD, professor of medicine at Harvard Medical School, said in a press release accompanying the study. “[Although] studies have identified associations between financial burden and patients’ treatment outcomes, quality of life and even survival among adults with cancer, as far as we know, this is the first to report these associations in survivors of childhood cancer.”

The researchers carried out a cross-sectional study of 580 survivors of childhood cancer and 173 siblings between May 2011 and April 2012. Participants completed a survey describing household income, out-of-pocket medical costs and financial burdens.

Childhood cancer survivors appeared more likely than their siblings to experience out-of-pocket medical costs of 10% or more of their annual income (10% vs. 2.9%; P < .01).

Survivors with higher out-of-pocket costs also reported lower incomes.

Among childhood cancer survivors, researchers found an association between higher out-of-pocket costs and hospitalization within the past year (OR = 2.3; 95% CI, 1.1-4.9), as well as a household income under $50,000 (OR = 5.5; 95% CI, 2.4-12.8).

Researchers also found a significant association between higher percentage of income spent on out-of-pocket medical costs and difficulty paying medical bills (OR = 8.9; 95% CI, 4.4-18), deferring care for a medical problem (OR = 3; 95% CI, 1.6-5.9), thoughts of filing for bankruptcy (OR = 6.6; 95% CI, 3-14.3) and skipping a test, treatment or follow-up (OR = 2.1; 95% CI, 1.1-4).

This study completed before the American Care Act was fully implemented, which the researchers acknowledge may have limited the findings.

“A more comprehensive understanding of the relationship between high out-of-pocket medical costs and the adverse effects of increased financial burden on cancer survivors could be instrumental in helping us identify those at risk for higher costs to help us address their financial challenges and improve health outcomes,” Nipp said in the press release. “It could also help inform policy changes to help meet the unique needs of cancer survivors and improve our understanding of how both higher costs and resulting financial burden influence patients’ approach to their medical care and decision-making.” – by Andy Polhamus

Disclosures: Nipp reports no relevant financial disclosures. Please see the full study for a list of all researchers’ relevant financial disclosures.