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

Financial hardship encompasses three domains:

  1. Material Conditions
    Example concepts within this domain:
    • Out-of-pocket expenses
    • Missed work
    • Reduced/lost income
    • Medical debt/bankrupcy
  2. Psychological Response
    Example concepts within this domain:
    • Feeling of distress due to costs of cancer care
    • Concern about wages/income meeting expenses related to costs of cancer care
  3. Coping Behaviors
    Example concepts within this domain:
    • Took less or skipped medication
    • Delayed or missed physician visit
Last Updated: 01 Apr, 2019