Perspectives on the financial burden of cancer care: Concurrent surveys of patients (Pts), caregivers (CGs), and oncology social workers (OSWs).

Abstract

9111 Background: In the United States, cancer treatment is often associated with substantial financial burden. To better understand the financial issues associated with cancer and their impact on Pts, concurrent surveys of Pts, CGs, and OSWs were undertaken in a collaborative effort between Kelton Research and the Association of Oncology Social Work (AOSW), funded by Millennium pharmaceuticals. Methods: Pts and CGs recruited from 2 national research panels and AOSW members were invited to complete online surveys in Oct–Nov 2009; 169 Pts, 131 CGs, and 153 OSWs responded. Pt/CG data are presented in aggregate. Results: 57% of Pts had experienced serious hardship relating to bills for cancer treatment, including depleted savings (40%) and bankruptcy (6%). 39% of Pts had a serious or catastrophic financial burden; among these Pts, costs negatively impacted ability to focus on recovery in 87%, and 75% constantly worried about financial issues. 51% of CGs tried to shield Pts from the financial aspects of treatment, while 73% of OSWs reported discussing financial issues with all/most of their Pts and 58% indicated this always or frequently had a positive result. While 62% of Pts indicated they were familiar with the treatment options covered by their health plan, OSWs perceived that only 4% of Pts with newly diagnosed cancer are aware of their options. OSWs witnessed the impact of financial issues on Pt adherence to treatment (Table). Although 69% of OSWs perceived themselves to be their Pts' primary resource for dealing with financial issues associated with cancer treatment, only 34% of Pts/CGs reported interacting with an OSW. Conclusions: The financial challenges of treatment are a key issue facing pts with cancer, which can interfere with treatment protocols and impact adherence. OSWs can support pts in working through financial and psychosocial barriers to treatment and enhanced quality of life, yet only a third of Pts report interacting with an OSW. Compliance issue OSWs witnessing, % Delay/failure to fill prescription 88 Asking for less expensive treatment 66 Skipped appointment to avoid co-pay 64 Skipped dose 58 Cut dose in half 58 Did not get/postponed treatment 56 Ended treatment early 52 No significant financial relationships to disclose.