Cancer treatments are supposed to help you get better, but ongoing research finds their high costs may be having the opposite effect. Here, Yousuf Zafar, MD, a cancer specialist at Duke, explains the negative impact that expensive cancer treatments have on patients’ well-being, and what you can do to prevent that from happening to you and your loved ones.
Red Flags of Financial Toxicity
Financial toxicity is the term doctors use to describe the burden that costly cancer treatments places on patients, Dr. Zafar explained. Patients cut back on food and clothing to pay for cancer care, they go into debt, declare bankruptcy or use up their retirement savings.
Studies show that even small differences in out-of-pocket expenses can impact how patients take their medication. For example, monthly copays higher than $50 can influence a patient’s decision to not take their drugs as prescribed.
“We have to discuss these red flags in clinic to make sure the treatments we are prescribing are not causing financial toxicity,” he said.
Doctors can help their patients by switching them to different, yet equally effective medications, and by pointing them toward resources.
Patients and Doctors Need to Talk Finances
Talking about the cost of medication is just starting to lose its stigma, Dr. Zafar said, although misconceptions persist among patients and their doctors that keep these important discussions from taking place.
“Our studies suggest patients equate cost with quality,” he said. “They want the best care regardless of cost, and don’t realize that these costs might be reduced without impacting the quality of their care.” Research also shows some patients are embarrassed to bring the subject up, or don’t feel it’s their doctors’ job to deal with the financial aspects of cancer care.
That’s understandable, Dr. Zafar said. “Sometimes we don’t know the costs. There is very little price transparency in our health care system.” And, historically, doctors have been reluctant to have the conversations. That’s changing as more doctors realize they can help their patients by switching them to different, yet equally effective medications, and by pointing them toward resources that can help.
“It’s no longer a taboo subject for the doctor or the patient,” Dr. Zafar said.
Your Doctor Isn’t Your Only Source of Information
Major medical centers often have financial resources designed to help patients in need. At Duke, for example, the financial assistance program includes social workers and financial counselors. “We also have pharmacists who can run prescriptions through patients’ insurance to see exactly what they need to pay out of pocket,” Dr. Zafar said. “These are all ways to engage the health care team before the patient incurs medical debt.”
That’s important. Waiting until you are far along in your treatment only makes it harder for doctors to help. Here’s what Dr. Zafar suggests patients do to avoid financial toxicity.
Heed This Advice
- Talk about costs early in the process. Don’t wait until you have accumulated medical debt to bring it up. The earlier the costs are addressed, the easier it is to find help. The ideal time to start the conversation is before your treatment has started.
- Talk about costs at your appointments. There are ways your doctor can help if he or she knows you are having a problem. If you are experiencing harm as a result of cost, your doctor wants to help you.
- Outside resources are available. Your doctor isn’t your only source of information and help. Foundations like the American Cancer Society, Livestrong, the American Society of Clinical Oncology and Cancer Support Community have a wealth of information on their websites about how to handle the costs of cancer care.