Tailored interventions needed to address ‘catastrophic’ financial burdens of cancer care
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Key takeaways:
- Nearly half of patients surveyed reported significant financial burden due to breast cancer.
- Survey respondents rated direct-assistance programs as most helpful to address financial burdens of cancer care.
Patients undergoing treatment for active breast cancer reported experiencing significant financial burden from cancer care, according to survey results.
The findings — presented at San Antonio Breast Cancer Symposium — indicate a need for patient-centered solutions to lessen financial burdens and optimize patient outcomes. These solutions could include direct assistance and patient education to improve knowledge, communication and self-advocacy, researchers concluded.
“When thinking about patient-centered care, we should ensure that we’re always first asking patients what they need, what has helped them in the past and what they wish they had when they were going through their breast cancer treatment,” Fumiko Chino, MD, radiation oncologist at Memorial Sloan Kettering Cancer Center and a member of Healio’s Women in Oncology Peer Perspective Board, told Healio. “The topic of financial toxicity is so important because there is a gap in the literature about asking patients what would truly help them on their cancer journey.”
Methods
Chino and colleagues aimed to assess patient burden from out-of-pocket expenses and perceived benefit of available or potential resources to reduce financial toxicity.
The analysis included 1,437 BreastCancer.org community members (94% women; 60% white; median age, 46 years; 75% on active treatment; 89% nonmetastatic disease and 11% with metastatic disease) who responded to an anonymous online survey.
“This research was conducted in partnership with BreastCancer.org — an amazing online community of women. We are so grateful for their support and for the people who are actively engaged in the community because they are the ones who provide us the information that leads to science,” Chino said. “This work is part of a large-scale evaluation of how breast cancer can affect work outcomes/return to work and also barriers to receiving best care from a cost perspective — for example, which patients couldn’t afford care or which patients skipped appointments because they couldn’t afford care.”
‘Catastrophic’ financial burdens
Results showed nearly half (47%) of the overall study population reported experiencing significant or catastrophic financial burden, with the highest burden reported among those with metastatic disease (61% vs. 45%; P < .001).
Survey respondents rated direct-assistance programs — such as reduced-cost medications, grants and transportation — as most helpful.
Respondents ranked a grant list, provider question checklist and access to professional advice as their first choice for potential resources.
“Direct assistance, such as help with out-of-pocket expenses for medications or medical bills, was generally reported as more helpful for patients,” Chino said. “There were also some differences between different populations in that not every person with breast cancer experienced the same needs.”
For example, someone with metastatic breast cancer may have different financial assistance needs than someone who is on curative treatment, she said.
“Or a Hispanic patient with breast cancer may have different needs than an Asian patient with breast cancer,” Chino said. “These findings highlight the concept that it is not ‘one size fits all’ for breast cancer treatment or for financial assistance. This all speaks to the larger issue at hand, which is that we need to do better about improving meaningful assistance during treatment [and] also through survivorship and we need to realize that financial burdens from cancer care are durable.”
Needed interventions
Tailored interventions are needed for solutions to come from within communities and be informed by more granular detailed analysis of what helps who and when, Chino told Healio.
“From this larger study about the financial burden of cancer care, what we’re really interested in addressing are some of the questions about how helpful coworkers and supervisors are, in terms of people taking appropriate leave from work — ideally paid leave — for example,” she said. “Moving forward, we can describe the problem all we want, but we ultimately want to highlight and invest in interventions.
“We know there are huge gaps in the delivery of health care, and we want to start trying to fill those gaps,” Chino added. “We need to make sure that we’re conducting individualized assessments for each person so that we can help facilitate getting them the immediate assistance they need.”
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Chino F, et al. Abstract PS04-09. Presented at: San Antonio Breast Cancer Symposium; Dec. 5-9, 2023; San Antonio.
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