Financial Hardship

The cost of cancer care has risen exponentially over the last 20 years, with new cancer drugs routinely priced over $120K per year. Additionally, commercial insurers are increasingly shifting healthcare costs to patients through higher co-pays and deductibles. As a result, a growing number of cancer patients experience financial hardship during cancer treatment. On average, cancer patients pay about $5,000/year in out-of-pocket costs, or nearly 10% of median household income. Prices higher than $10,000 a month for individual drugs and biologic agents, however, are not uncommon. As a result, patients have reported difficulty paying their mortgage and utilities and have taken out loans or reduced spending on necessities such as food and clothing to pay for medical bills. With the development of innovative cancer therapies, there is growing concern that the exorbitant cost of these therapies will limit patients’ access to their potential benefits.

Altice, C.K., et al., Financial Hardships Experienced by Cancer Survivors: A Systematic Review. J Natl Cancer Inst, 2017. 109(2).
The figure below shows the three domains of financial hardship - material conditions, psychological responses, and coping behaviors.

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The figure below shows the three domains of financial hardship - material conditions, psychological responses, and coping behaviors.

Financial hardship encompasses three domains: (1) material conditions, including direct medical costs, indirect costs, and other factors such as work disruptions; (2) psychological responses such as stress caused by actual or perceived reductions in material conditions attributable to cancer or its treatment; and (3) coping behaviors comprising strategies used to manage material conditions and psychological responses (e.g., delaying or missing medication, missing medical appointments, declaring bankruptcy). Research is needed to better understand and address the multiple domains of financial hardship to improve patient’s quality of life and health outcomes.