4.2 Article

Society of Behavioral Medicine (SBM) position statement: support increased knowledge and efforts to address the financial burden associated with cancer treatment

Journal

TRANSLATIONAL BEHAVIORAL MEDICINE
Volume 11, Issue 6, Pages 1289-1291

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/tbm/ibaa073

Keywords

Cancer; Economics; Financial toxicity

Funding

  1. National Institutes of Health/National Cancer Institute [U54CA202995]
  2. Patient-Centered Outcomes Research Institute Eugene Washington Engagement Award [10629-UO1]

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Financial toxicity, as a result of cancer diagnosis, can lead to depletion of assets and financial insolvency for patients in a short period of time. Despite a majority of Americans wanting to discuss care costs with their healthcare providers, only a small percentage actually engage in these conversations, potentially resulting in patients forgoing necessary care.
Millions of individuals and their families struggle with both treatment-related and out-of-pocket (OOP) economic repercussions of a cancer diagnosis, an effect increasingly referred to as financial toxicity. In 2014, the Agency for Healthcare Research and Quality (AHRQ) estimated the total U.S. expenditures for cancer at $87.8 billion dollars with patient OOP costs accounting for $3.9 billion dollars (2014). These figures do not take into account indirect costs, such as those from lost earnings. As a result, financial toxicity can extend well beyond the active treatment phase and have a substantial impact on a household's economic reserve and financial resilience well into the future. Of the 9.5 million U.S. adults aged 50 years and older diagnosed with cancer (2000-2012), 42.2% have depleted their assets at 2 years and 38.2% were financially insolvent in 4 years. Bankruptcy rates are 2.65 times higher among cancer survivors than matched controls. A full 70% of Americans want to have conversations about the costs of care with their health care providers, but only 28% report doing so. Delaying or deferring these conversations can have major financial consequences for patients. According to a polling conducted for the Robert Wood Johnson Foundation (RWJF) by Avalere Health, almost 20% of patients report forgoing care when they have questions about costs A critical element to achieve this is to have accurate cost information, including health care insurance coverage policies. Specifically, while patients and their families look to their health care providers to help them better navigate the cost implication of their treatment choices, most who are willing to undertake this challenging task need to have accessible and comprehensive (including direct and indirect) cost information to facilitate the discussion.

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