Study: Women at High Risk of Breast Cancer Face Financial Hurdles Regardless of Insurance

Women at high risk for breast cancer still face cost-related barriers even when they have health insurance, according to a new study published in the Journal of Genetic Counseling. According to the study authors, the findings suggest a need for greater transparency in health care pricing as well as policies eliminating financial obstacles to catching cancer early.

“Financial barriers seem to regularly impede access to critical information that high-risk women can only get through genetic counseling and testing, and keep them from using regular screenings that could catch cancers in the earliest and most treatable stages,” said Tasleem Padamsee, PhD, assistant professor of health services management and policy at Ohio State, in a press release. “For women at the highest levels of risk, financial impediments can also put the most effective preventive surgeries and medications entirely out of reach.”

The study, which involved conducting in-depth interviews with 50 women deemed at high risk of breast cancer based on factors like family history, found that financial constraints affect women across the financial spectrum. Respondents from all income groups reported that they worry about the financial impacts of prevention choices and avoiding taking steps they can't afford or don't know if they can afford. Further, these financial concerns are influenced by more than just the individual’s financial situation, with respondents indicating that they are also influenced by broader social and political issues such as lack of price transparency on the part of insurance companies, which often results in women having to guess which services are covered and which are not.

“Underinsurance was a really big factor, even for those women who have private insurance, they come across a lot of hurdles with requesting coverage for genetic testing, counseling, risk-reducing surgeries and enhanced breast screening,” said Rachel J. Meadows MPH, PhD(c), in the release. “These women are managing other priorities, including weighing paying for care for chronic diseases they currently have against managing a future risk. And they have other financial demands, including raising children and supporting other family members.”

Many high-risk women also worry about the risk of future discrimination if they have genetic testing, according to the researchers, although current law prevents genetic discrimination. Further, the researchers said the findings suggest a need for regulatory changes, such as long-term guarantees against genetic discrimination, and stronger requirements that insurance companies disclose their full benefits and co-pays in more transparent and comprehensible ways.

“These changes could improve women's ability to access high-risk care, reduce the number and severity of future cancers, and avoid future cancer treatment costs for both patients and payers,” Padamsee said in the release.

REFERENCE

Insurance isn't enough for women at high risk of breast cancer [news release] EurekAlert; April 21, 2021. Accessed April 22, 2021. https://www.eurekalert.org/pub_releases/2021-04/osu-iie042121.php