Although breast cancer survivors appear to have lower OOP monthly costs ($316) compared with survivors of other cancer types, 1 study reported that 45% had job-related income loss resulting in a mean indirect annual cost of $8236, with a maximum loss of $13,462 per month for a 3-month period. In another study of breast cancer survivors, the mean number of lost work days was 42.1.
Not surprisingly, OOP and indirect costs can lead to medical debt, depletion of assets, and bankruptcy. One study found that cancer survivors paid their medical expenses by using income or savings (80%), credit card (10%), or borrowed from family or friends (7%). Patients with complications were more likely to spend their savings, borrow, or obtain loans to pay expenses.
Psychological response was also high among cancer survivors. In a study of women with breast or gynecologic cancers, 47% were concerned about lost wages, 68% were concerned about medical costs, and 49% reported financial stress, and, as a result, had poorer functional, emotional, and physical well-being, and were at risk of depression.
Financial hardship can also negatively affect cancer treatment: up to 45% of cancer survivors skip, take less, or avoid filling prescription medication, and up to 20% reduce their spending on non-cancer-related health care for themselves or their family members.
Dr Yabroff told Cancer Therapy Advisor that the study found “financial hardship was common among recently diagnosed and long term cancer survivors, suggesting a role for patient-provider discussions for oncologists as well as primary care clinicians and other providers.”
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Dr Yabroff noted that financial hardship has multiple aspects and that “strategies for addressing financial hardship will vary based on whether patients are at risk for or are experiencing financial hardship related to material conditions, psychological responses, coping behaviors, or a combination of these aspects of financial hardship.”
- Altice CK, Banegas MP, Tucker-Seeley RD, Yabroff KR. Financial hardships experienced by cancer survivors: a systematic review. J Natl Cancer Inst. 2016 Oct 20;109(2). doi: 10.1093/jnci/djw205