There is no facet of a person’s life that goes untouched in the presence of a cancer diagnosis. The specific term that refers to the monetary struggles of a patient that come about as a result of the cost of their medical care is financial toxicity. Financial toxicity has far-reaching adverse effects, including decreased health and quality of life because a person may be forced to reduce the money they spend on things like healthy foods and other necessities, and they will likely experience heightened levels of stress.
“Cancer patients are more likely to have financial toxicity than people without cancer.”
Cancer patients experience financial toxicity for a number of reasons:
- Depending on the severity of their cancer, a person may be prevented from working full-time or at all. This will be a particularly challenging outcome if the patient is their household’s breadwinner.
- Cancer treatment is expensive. Research shows that care can cost up to R1 million a year for cancer patients in South Africa and that the average cost of specialty cancer medicines is R23,533 per item. The high cost is largely due to the country’s approach to patenting which keeps prices high and prevents generics from entering the market. To add insult to injury, medical aid schemes in South Africa do not automatically cover cancer treatment costs.
- Non-medical costs also place a financial burden on cancer patients. These may include transportation to medical facilities, mental health support, dietary supplements, and childcare costs.
It has been suggested that an increased focus on value-based care could help to reduce financial toxicity. As opposed to volume-based care, value-based care focuses on quality over quantity, is patient-centric, and aims to provide “treatments which promote the best patient outcomes while driving down costs.” In a value-based healthcare system, providers are paid based on the outcomes of their patients.
Financial navigation is a term used to describe efforts aimed at reducing the effects of financial toxicity on cancer patients. Solving a problem starts with understanding it, so one of the keys to successful financial navigation is understanding a patient’s risk factors for financial toxicity (eg. household income, age, race, type of cancer). A higher degree of transparency on behalf of medical practitioners with regard to the costs of cancer care will allow patients to make more informed decisions. An individualized approach can then be tailored by a multidisciplinary team to respond to each patient’s unique circumstances. Support measures include guiding patients to resources “such as financial assistance (eg, mitigating prescription medication costs or nonmedical day-to-day expenses), education (eg, enhancing financial literacy or debt planning), and health insurance enrollment and optimization.”
If you are ever diagnosed with cancer, your best protection against the burden of financial toxicity is to ensure that you have a cancer insurance policy in place.