Cancer Treatments Costlier Than Patients Think

One-third of insured cancer patients may pay more out-of-pocket for treatment than expected.

High out-of-pocket costs for prescription drugs is a growing concern for many Americans, especially those treated with costly specialty drugs. For some patients, the cost of healthcare and drugs may cause them to forego treatment or cut down on doses. This practice can be dangerous for all patients, but it can be particularly life-threatening for those with cancer.

A new study published by JAMA Oncology found that one-third of insured patients with cancer paid more out-of-pocket for their treatments than they expected.

The study results showed that co-payments and deductibles may lead to financial distress among insured patients with cancer, regardless of income level or disease stage.

Financial distress can affect mental and physical health, especially for patients who stop treatment due to costs.

“This study adds to the growing evidence that we need to intervene,” said senior author Yousuf Zafar, MD. “We know there are a lot of barriers that prevent patients from talking about cost with their providers. We need to create tools for patients at risk of financial toxicity and connect them with resources in a timely fashion so they can afford their care.”

The authors evaluated interviews of 300 insured patients with cancer. They found that 16% of patients reported high or overwhelming financial distress.

Patients with the most distress were spending one-third of their household income on healthcare costs, not including premiums, according to the study. A majority of these patients had private health insurance.

Patients who reported little to average financial stress were spending approximately 10% of their household income on healthcare costs. More than half of these patients had private insurance, while 39% had government-subsidized insurance, according to the study.

The authors also found that having higher-than-expected out-of-pocket costs was linked to high levels of financial stress. These individuals were also observed to be less willing to pay for cancer treatment, which may impact outcomes.

These results suggest that more should be done to control specialty drug costs and help patients gain access to financial assistance, especially for those with private insurance who may be spending more on treatment.

“Overall, the patients in the study were paying an average of 11% on out-of-pocket costs for their cancer treatment,” said lead author Fumiko Chino, MD. “Those who spend more than 10% of their income on health care costs are considered underinsured. Learning about the cost-sharing burden on some insured patients is important right now, given the uncertainty in health insurance.”