Open Access Peer-reviewed Review

Financial assistance programs for cancer patients

Article Sidebar

Studies of financial assistance programs
Download PDF
Submitted   Jul 26, 2021
Published   Sep 17, 2021
Issue    Vol 3 (2021)
DOI   10.25082/CCR.2021.01.007

Views

1792

Downloads

952

Citations

PlumX Metrics

Main Article Content

Steven S. Coughlin corresponding author
1. Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA; 2. Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
Lorraine T. Dean
1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 2. Department of Oncology, Johns Hopkins Bloomberg School of Medicine, Baltimore, MD, USA
Jorge E. Cortes
1. Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA; 2. Georgia Cancer Center, Augusta University, Augusta, GA, USA

Abstract

Background:  The high costs of oncology care can lead to financial stress and have deleterious effects on the well-being of patients and their families.  However, only a handful of financial assistance programs for cancer patients have been implemented and evaluated to date. 
Recent findings:  Key features of reported programs include instrumental support through financial navigation or education for patients, and financial or charitable support for healthcare costs. Only one of the programs successfully reduced actual out-of-pocket costs for patients, though others were associated with psychosocial benefits or increased knowledge of financial resources.  Four of the 5 programs evaluated to date were pilot studies with small sample sizes, and most lack control groups for comparison.
Conclusions:  Additional studies are needed that include larger sample sizes and with comparison groups of cancer patients in order to determine whether the counseling and navigator programs are effective in addressing financial distress in this patient population.  Of particular interest are programs designed for low-income patients and those who lack health care insurance.  Financial assistance programs that implement solutions at different levels of the healthcare system (individual patients, providers, healthcare institutions) are more likely to be effective.  Multi-level interventions are needed that address the systems in which patients access care, the actual costs of services and drugs, and the individual needs of patients in order to reduce financial hardship for cancer patients.

Keywords
cancer, costs, financial distress, financial toxicity

Article Details

How to Cite
Coughlin, S., Dean, L., & Cortes, J. (2021). Financial assistance programs for cancer patients. Current Cancer Reports, 3(1), 119-123. https://doi.org/10.25082/CCR.2021.01.007
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

References

  1. Zafar SY. Financial toxicity of cancer care: it’s time to intervene. Journal of the National Cancer Institute, 2016, 108(5): 1-4. https://doi.org/10.1093/jnci/djv370
  2. Dean LT, Schmitz KH, Frick KD, et al. Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA. Journal of Cancer Survivorship, 2018, 12: 306-315. https://doi.org/10.1007/s11764-017-0669-1
  3. Coughlin SS and Dean LT. Cancer survivorship care plans, financial toxicity, and financial planning alleviating financial distress among cancer survivors. Supportive Care in Cancer, 2019, 27: 1969-1971. https://doi.org/10.1007/s00520-019-04703-6
  4. Coughlin SS, Moore JX and Cortes JE. Addressing financial toxicity in oncology care. Journal of Hospital Management and Health Policy 2020, in press. https://doi.org/10.21037/jhmhp-20-68
  5. Desai A and Gyawali B. Financial toxicity of cancer treatment: moving the discussion from acknowledge of the problem to identifying solutions. EClinicalMedicine 2020, in press. https://doi.org/10.1016/j.eclinm.2020.100269
  6. Shankaran V, Leahy T, Steelquist J, et al. Pilot feasibility study of an oncology financial navigation program. Journal of Oncology Practice, 2018, 14(2): 122-129. https://doi.org/10.1200/JOP.2017.024927
  7. Pisu M, Azuero A, McNees P, et al. The out of pocket cost of breast cancer survivors: a review. Journal of Cancer Survivorship, 2010, 4: 202-209. https://doi.org/10.1007/s11764-010-0125-y
  8. Carrera PM, Kantarjian HM and Blinder VS. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. CA: A Cancer Journal for Clinicians, 2018, 68(2): 153-165. https://doi.org/10.3322/caac.21443
  9. Jagsi R, Pottow JA, Griffith KA, et al. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. Journal of Clinical Oncology, 2014, 32(12): 1269-1276. https://doi.org/10.1200/JCO.2013.53.0956
  10. Altice CK, Banegas MP, Tucker-Seley RD, et al. Financial hardships experienced by cancer survivors: a systematic review. Journal of the National Cancer Institute, 2017, 109(2). https://doi.org/10.1093/jnci/djw205
  11. Watabayashi K, Steelquist J and Overstreet KA. A pilot study of a comprehensive financial navigation program in patients with cancer and caregivers. National Comprehensive Cancer Network, 2020, 18(19): 1366-1373. https://doi.org/10.6004/jnccn.2020.7581
  12. de Souza JA, Yap BJ, Wroblewski K, et al. Measuring financial toxicity as a clinically relevant patientreported outcome: The validation of the COmprehensive Score for financial Toxicity (COST). Cancer, 2017, 123(3): 476-484. https://doi.org/10.1002/cncr.30369
  13. ThorntonMand Travis SS. Analysis of the reliability of the modified caregiver strain index. The Journals of Gerontology: Series B, 2003, 58(2): 127-132. https://doi.org/10.1093/geronb/58.2.S127
  14. Sadigh G, Gallagher K, Obenchain J, et al. Pilot feasibility study of an oncology financial navigation program in brain cancer patients. Journal of the American College of Radiology, 2019, 16(10): 1420- 1424. https://doi.org/10.1016/j.jacr.2019.07.014
  15. Yezefski T, Steelquist J, Watabayashi K, et al. Impact of trained oncology financial navigators on patient out-of-pocket spending. The American Journal of Managed Care, 2018, 24(5 Suppl): 74-79.
  16. Kircher SM, Yarber J, Rutsohn J, et al. Piloting a financial counseling intervention for patients with cancer receiving chemotherapy. Journal of Oncology Practice, 2019, 15(3): e202-e210. https://doi.org/10.1200/JOP.18.00270
  17. Lentz R, Benson AB and Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. Journal of Surgical Oncology, 2018, 120(1): 85-92. https://doi.org/10.1002/jso.25374
  18. Gao L, Joseph J, Santoro-Levy M, et al. Use of a prescription-assistance program for medically uninsured patients with cancer: case study of a public hospital experience in New York State. Journal of Oncology Practice, 2014, 10(2): 104. https://doi.org/10.1200/JOP.2013.001101
  19. Zafar SY and Peppercorn JM. Patient financial assistance programs: a path to affordability or a barrier to accessible cancer care? Journal of Clinical Oncology, 2017, 35(19): 2113-2116. https://doi.org/10.1200/JCO.2016.71.7280
  20. Dean LT, George M, Lee KT, et al. Why individual-level interventions are not enough: systems-level determinants of oral anticancer medication adherence. Cancer, 2020, 126(16): 3606-3612. https://doi.org/10.1002/cncr.32946