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The financial burden of cancer care: do patients in the US know what to expect?

Pages 835-842 | Published online: 01 Oct 2014
 

Abstract

Patients in the USA face potentially high financial burdens from the costs of cancer care, distinct from the challenges of societal costs and the economic impact of the disease itself. Survey data suggest that many physicians, let alone many patients, are uninformed about the costs of cancer care. Greater cost transparency and both physician and patient education will be necessary to improve patient understanding of costs and to reduce financial burdens. While many patients wish to discuss costs of care, few report such conversations, and there is no consensus on the optimal setting, timing, content or goals for such discussions. This paper reviews the challenge of appropriately educating patients regarding financial burdens of cancer.

Acknowledgement

J Peppercorn is supported by the Greenwall Foundation for Bioethics.

Financial & competing interests disclosure

J Peppercorn has worked as a consultant for Genentech, has received research support from Novartis, and his wife is a medical director for GlaxoSmithKline. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

  • Costs of treating cancer are high and increasing and have potential to impose a catastrophic burden on patients, which can impede access to care and impact cancer outcomes.

  • There is a need to differentiate between the direct burdens of out-of-pocket expenses for cancer care on patients, the economic impact of a cancer diagnosis itself and the societal costs of cancer care.

  • Surveys of patients consistently show that many patients experience financial hardship as a result of costs of cancer care.

  • While many patients wish for greater information on direct costs of care, there is little consensus on the ideal content, timing, setting or goals for discussions of cost in the clinic.

  • Research should increasingly focus on understanding the impact of discussions of cost and interventions to improve clinician and patient information regarding costs.

  • Our goal should be to reduce financial and other barriers to high-value cancer care, while discouraging low-value care.

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