Study Finds

Even With Health Insurance, Cancer Patients Stymied By High Out-Of-Pocket Expenses

WINSTON-SALEM, N.C. — The huge costs of treating cancer is causing widespread financial distress and hardship for insured patients of all income levels and with all stages of cancer, according to the findings of a new study.

Costs resulting from copays and deductibles make the cost of treating cost much higher than patients expected, particularly those who are insured. Perhaps even more troubling, the study’s authors say that the burden is creating difficult financial stress for patients and their families, even leading some to second guess whether or not to enter treatment.

In the study, led by Duke University medical oncologist Dr. Yousuf Zafar, researchers found many cancer patients are severely burdened by what some call the “financial toxicity” that erodes their mental and physical state, causing patients to stop pursuing treatment because they can’t afford it.

As if cancer patients don’t deal with enough stress from the condition itself, a new study finds that many actually reconsider treatment altogether because of high out-of-pocket costs, even with insurance.

“This study adds to the growing evidence that we need to intervene,” suggests Zafar in a Duke media release. “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.”

Of the 300 insured cancer patients surveyed by Zafar and his team, 16% reported high or overwhelming financial distress. The most distressed patients were spending, on average, about a third of their household income on their medical care, excluding health insurance premiums. About 60% of this group relied on private health insurance for their healthcare coverage.

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Patients with low or average financial stress spent about 10% of their household income on their care. Over half of this group had private health insurance, and 39% of this group had government-subsidized health insurance.

“Overall, the patients in the study were paying an average of 11 percent on out-of-pocket costs for their cancer treatment,” says lead author Dr. Fumiko Chino, a resident in radiation oncology at Duke Health. “Those who spend more than 10 percent 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.”

These insights could be used to provide better coverage for cancer patients in the future to try and limit the number of people who refuse treatment because of financial issues.

The full study was published in November in the journal JAMA Oncology.

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