Opportunities for interventions to reduce the financial toxicity of treatment for childhood cancer.

Abstract

e18797 Background: Cancer-related financial toxicity is an unaddressed side-effect of childhood cancer, with consequences for household financial health and quality of care, including increased risk for relapse, and decreased survival rates. This project identified opportunities along the cancer journey when interventions could reduce risk of cancer-related financial toxicity for families of children with cancer. Methods: Seventeen caregivers of children diagnosed with cancer attended focus groups (n = 3) to discuss how they navigated the financial side of cancer. We used the concept of “social navigation” to guide thematic analysis of transcripts. Social navigation is relevant to understanding the financial side of cancer because it acknowledges and examines how people act when unanticipated disruptions (e.g. health, financial) create instability in their lives. Results: Five major themes and twenty-three sub-themes emerged: 1. disruption experienced by family (emotional shock, hospital stay, travel for outpatient care, unpredictability of treatment); 2. caregiver’s management of disruption (time-off work, restructured routines); 3. financial consequences (reduced income, direct and indirect medical expenses, debt accumulation); 4. caregiver’s management of financial consequences (increased work hours, navigated insurance coverage, requested financial assistance, cut-back expenses, used financial reserves, “fight for everything”); 5. interventions (financial assistance, proactive support for insurance and resource navigation, credit advocacy, housing and meals for family during inpatient stays, parking support, online workshops, streamlined application process for financial assistance, expanded eligibility criteria for financial assistance, and research on treatment that can be administered at home). Conclusions: Focus groups identified opportunities for interventions to reduce cancer-related financial toxicity for families of children with cancer throughout the cancer journey. With collective actions from the ecosystem of for-profit, non-profit, and public sectors these opportunities can become programs that may benefit cancer patients, families, and society.