One Third of Cancer Patients Report Their Out-of-Pocket Treatment Costs are Higher Than Expected

While insurance coverage can help make the cost of cancer treatment more manageable, a new study suggests that it may not do enough to offset the expense. According to researchers at Duke Cancer Institute, one third of insured cancer patients reported paying more out-of-pocket costs for their treatment than they originally anticipated.

The study suggests that patients in various income brackets diagnosed with different stages of cancer could all be at risk of experiencing financial distress as a result of mounting copays and deductibles. The findings were published in a research letter in the journal, JAMA Oncology.

According to senior study author Dr. Yousuf Zafar, a medical oncologist at Duke, this financial burden can have a significant effect on a patient’s physical and mental well-being. In some cases, financial issues can prompt patients to stop treatment altogether, further endangering their health.

“This study adds to the growing evidence that we need to intervene,” said Zafar. “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.”

In the current study, Zafar and his colleagues interviewed 300 insured cancer patients to assess their level of financial distress. Sixteen percent of those patients reported spending around 33 percent of their total income on healthcare costs associated with their cancer treatment.

This number did not include insurance premiums, which can be significant for patients with chronic illness. Over 60 percent of patients who reported spending the most on healthcare costs relied on private insurance, and said they were experiencing “high or overwhelming financial distress.”

In contrast, patients spending about 10 percent of their household income on cancer treatment and other healthcare costs reported experiencing low or average levels of financial stress. Over 50 percent of these low-stress patients had private insurance, with nearly 40 percent relying on government-subsidized coverage.

Clearly, higher out-of-pocket expenses have a direct impact on the level of financial stress experienced by the patient. However, the study team also found that patients experiencing higher levels of financial stress were less likely to pay for their cancer care.

“Overall, the patients in the study were paying an average of 11 percent on out-of-pocket costs for their cancer treatment,” said 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.”