MS17.02 Financial Toxicity and Out of Pocket Costs

Abstract

Increasingly, patients are sharing the brunt of high cancer care costs, even when patients have insurance, due to increases in co-payments and high-deductible health plans. The out of pocket (OOP) costs borne by patients with cancer in the US was $4 billion in 2014. In an analysis between 2011-2014, the average per patient OOP costs in the first year after diagnosis were between $3,600 and $5,500 depending on the cancer type. The OOP costs were the highest on the month of diagnosis and declined subsequently but never reached the pre-diagnosis level. In countries without health insurance system, patients bear 100% of the drug costs OOP. This usually means that the patient and family must cut down on other daily living expenses or draw from savings and even sell their properties to compensate for the extra health care expenditures. Sometimes, it can mean treatment non-adherence, bankruptcy, or personal or familial stress. Such adverse outcomes due to economic impact of cancer treatment on patient and family are now collectively referred to as “financial toxicity” of cancer treatment. Financial toxicity refers to all the downstream detrimental effects on the survival, quality, and daily life activities of patients and their families as a result of excess financial strain caused by the diagnosis of cancer. In my presentation, I will discuss the causes and effects of financial toxicity in the context of lung cancer and propose some solutions. financial toxicity, cost of cancer drugs, out-of-pocket