The heavy burden of financial stress from accumulating medical bills can lower the quality of life for cancer patients, even for those who have completed treatments and are cancer-free, according to a new study by Duke Medicine.
The study, published in the Journal of Oncology Practice, advances ongoing research on the topic of “financial toxicity” from cancer care and whether the costs for treatment can affect a patient’s outlook and outcomes.
“Our focus has been on how the cost of cancer care impacts a patient’s well-being, and we found that patients are at risk of experiencing financial harm as a result of the treatments we prescribe,” said Dr. Yousuf Zafar, M.D., M.H.S., associate professor at Duke and lead author of the study.
“Even for patients who have insurance, those out-of-pocket costs add up,” Zafar said. “Patients are at risk for not adhering to their treatments due to cost. They may have to borrow, spend their savings, or cut back on basics like food and clothing, all to help pay for care.”
The researchers analyzed patient surveys and medical record data for 1,000 people who had been diagnosed with colorectal or lung cancers at five health care systems in the U.S.; 111 patients were at an advanced stage of cancer, and 889 of the patients were cancer-free. Nearly half reported difficulty making ends meet on their household income.
Overwhelming medical bills can lead to what researchers call “financial toxicity” and can have a negative effect on patients’ well-being regardless of their income, employment, the status of the cancer and other health problems. A high financial burden was connected to a poorer health-related quality of life.
Previous research has found that cancer patients are reluctant to discuss out-of-pocket costs with their doctors because of the fear that doing so could result in a lower quality of care. Zafar plans to continue studying interventions that might improve the quality of life for patients weighed down with medical bills.
The findings should encourage dialogue among providers on how to cut out-of-pocket costs for treatments, noted Zafar. For example, it would be beneficial to ask the pharmacist to run expensive prescriptions through a patient’s insurance plan before sending the patient to the pharmacy.
“Financial toxicity is potentially harming our patients,” Zafar said. “Without a doubt, we have our patients’ best interests in mind, so if we become more cognizant of that, we’re more likely to act on it.”
“We as physicians don’t bear the burden of finding the answer on our own,” Zafar added. “We might not have all the answers on how to decrease our patients’ costs, but we have people around us — pharmacists, financial advisors, social workers — who are just a phone call away.”