The diagnosis of cancer carries many different levels of burden and fear on its own. But cancer impacts more than just physical and emotional health. Imagine receiving that diagnosis while your family is already navigating the strain of financial insecurity. Financial toxicity is defined as the challenge and distress for patients and families caused by the out-of-pocket costs and other financial/economic impacts of treatment. Many studies have found that financial toxicity can lead to a larger decline in quality of life than the physical or emotional distress of cancer itself.
While innovations in cancer care have improved health outcomes, they have also made cancer one of the most expensive medical conditions to treat. Numerous tests, radiation, surgery, therapeutics and hospitalizations all add to the treatment price tag. Beyond that, cancer may affect a patient or their caretaker’s ability to work or live independently and may cause increases in insurance premiums and co-payments/co-insurance.
A recent study evaluated financial distress in patients with gynecologic cancer and determined that “the presence of financial distress was associated with a 16-point decrease” in quality of life.
This toxicity can lead patients or their families into debt or even bankruptcy, which has been demonstrated to be a risk factor for mortality – “those who reach the point of financial insolvency after a cancer diagnosis have significantly poorer outcomes than those who do not.”
What makes financial toxicity and distress even more damaging is patients’ reluctance to discuss their financial concerns with their oncologists.
A 2015 article suggests that “making ‘financial health’ a routine part of clinical assessment may help overcome the reluctance associated with discussing personal finances, identify patients at greatest risk for high financial burden, and prompt earlier financial assistance.”
Financial health discussions between oncologists, patients, and families can be enhanced through use of tools such as COST - Comprehensive Score for Financial Toxicity – a validated financial toxicity screener with questions that focus on financial security, job security, and other pressing topics.
The American Cancer Society also created a set of questions that patients can ask their oncologist – for example, “How long will I need to be treated and what is the estimated total cost of my proposed treatment plan? Are there any treatment options that might cost less, and how well will they work?”
What’s critical is early identification, screening, and open dialogue about financial toxicity and distress. These steps can mitigate financial toxicity and distress by “prompt[ing] timely clinical actions before problems escalate and prioritize[ing] financial discussions and referrals for counseling and navigation programs, where available, as well as manag[ing] the impacts of distress resulting from FT.”
For marketers and healthcare professionals, these insights further validate the need to center the patient voice, prioritize health literacy and strive to create a brave space for patients and healthcare professionals to communicate with transparency.