Paying for cancer treatment can be a major burden for many people.
Growing numbers of people with cancer are seeing positive outcomes. In January 2014, there were around 14.5 million cancer survivors in the US, and this figure is expected to rise to 19 million by 2024, as treatments improve and people live longer.
But as medical costs escalate, out-of-pocket contributions are creeping up. Patients with cancer are estimated to spend $1,730-$4,727 per year on treatment and related costs, depending on insurance status.
While research into treatments flourish, few studies have looked at the financial burden on survivors.
21% worry about large medical bills
To investigate, Hrishikesh Kale and colleagues of Virginia Commonwealth University School of Pharmacy in Richmond, VA, analyzed medical expenditure data from 2011 for 19.6 million cancer survivors.
Financial burden was considered to be present if the patient had borrowed money, declared bankruptcy, worried about paying large medical bills, had been unable to meet the cost of medical care visits or had made other financial sacrifices.
Nearly 29% of cancer survivors in the US experienced at least one financial problem resulting from cancer diagnosis, treatment or long-term effects of treatment.
Of all cancer survivors surveyed, 21% worried about paying large medical bills, 11.5% were not able to pay for medical care visits, 7.6% had borrowed money or gone into debt, 1.5% declared themselves bankrupt and 8.6% had made other financial sacrifices.
These financial difficulties were associated with a physical and mental health-related reduction in quality of life, including a higher chance of depression and psychological distress.
They were also more likely to worry about their cancer recurring, compared with survivors who did not have financial problems.
The higher the number of financial problems, the more a survivor's quality of life was affected by these factors.
Some types of financial problems had a more intense impact. Bankruptcy was associated with a 20-25% drop in quality of life, and a reduction of 6-8% was linked to concerns about paying large medical bills.
Need for policies to minimize costs
Co-author Dr. Norman Carroll, PhD, comments that health-related quality of life and psychological health could be improved by policies and practices designed to minimize out-of-pocket costs for patients.
Integrated efforts are needed, he says. Oncologists, payers, survivorship care programs, pharmaceuticals and patients and their family members could use these results to work toward a solution.
Before selecting treatments for cancer patients, Mr. Kale proposes that oncologists should consider offering more economical options but with similar outcomes. They also need to discuss treatment costs with patients and involve patients in the decision-making process regarding therapy.
"Cancer patients and family members should educate themselves regarding survivorship issues, coverage and benefit design of their health plans and organizations that provide financial assistance."
He mentions that there are care programs for cancer survivors that can assist those facing severe financial burden and help them to cope with any psychological stress, anxiety and depression that may arise.