Strategies for Helping Patients Reduce Their Financial Burden During Care

Jason Lockard, CMOM
Regional Practice Administrator
Beaumont Medical Group
Southfield, MI
Bettinna Signori, CMOM-HEM/ONC
Regional Practice Administrator
Beaumont Medical Group
Southfield, MI

Cancer remains one of the costliest diseases to treat in the United States. According to a 2020 report published by the American Cancer Society Cancer Action Network, the out-of-pocket costs patients faced in 2018 totaled $5.6 billion.1 Furthermore, evidence shows that the total amount attributed to direct cancer-related healthcare spending in 2015 was $183 billion, a number that is estimated to increase to approximately $246 billion by 2030.2

Unfortunately, an increasing percentage of the costs associated with cancer treatment is being shifted to patients, resulting in higher deductibles, copays, and coinsurance amounts. The COVID-19 pandemic has further increased the financial burden of many patients, as more of them experience unemployment and loss of their health insurance plans.3 An important responsibility of today’s oncology providers is to help patients locate resources that can alleviate the rising costs associated with their treatment.

Financial Assistance

Patients with cancer continue to face rising out-of-pocket costs, a trend that can limit healthcare access and the ability to pay for high-quality services. Frequently, these costs extend beyond copays or deductibles to things such as travel expenses, living expenses, and even caregiver expenses, all of which contribute to their financial burden. Therefore, it is critical that patients are directed to resources that can help mitigate both direct and ancillary costs.

For many patients, the thought of searching for financial assistance can feel overwhelming. Fsortunately, there are several organizations that have done a lot of the leg work for them. One such organization is Cancer Care News (https://cancercarenews.com/more-cancer-freebies/grants/), which offers a comprehensive directory of resources that provide grants to patients. These grants can be used for various expenses, including those related to transportation, lodging, support services, and treatment costs. The directory is updated daily, and there is no fee to apply for these grants.

Another helpful resource is the Leukemia & Lymphoma Society (https://lls.org/support-resources/other-helpful-organizations/financial-resources/mortgage-rent-and-utility), which features a directory of organizations and groups that help patients with utility and housing expenses.

In addition, the American Cancer Society (www.cancer.org) remains an important resource for patients diagnosed with cancer. Just a few of the many free services offered by this organization include transportation to medical appointments and lodging when the treatment site is far from a patient’s home.4

Of course, a significant amount of the financial burden facing patients with cancer is related to the direct costs of treatment. The speed with which new therapies are being approved, especially in the area of precision medicine, is mind-blowing, but these innovations come with a high price tag. According to a 2015 analysis, some patients enrolled in the Centers for Medicare FMedicaid Services’ Part D plan may face $12,000 annually in out-of-pocket costs for just 1 drug.5 The good news is that many pharmaceutical companies now provide financial assistance and other support services immediately with the launch of a new cancer medication. Information on the types of patient assistance programs available is typically found on the manufacturers’ websites.

Patients can also seek help through NeedyMeds (NeedyMeds.org), a national nonprofit organization that offers information on drug company financial assistance programs. Its website allows individuals to search for programs by diagnosis or medication name. There are also links to government programs and organizations that offer money-saving coupons.

Utilizing Biosimilars

It is important for patients to have access to more affordable drug alternatives when they are available and medically appropriate. In some instances, providers may be able to lower the cost of treatment for patients by prescribing a biosimilar alternative to a branded drug. In its report on cancer care, the American Cancer Society Cancer Action Network stated that it supports efforts to ensure that biosimilar and generic drugs are available to patients either through direct prescription or appropriate pharmacy substitution of interchangeable products, and endorses policies that would increase access to these medications.1

Hiring a Financial Navigator

Another important strategy for oncology practices to consider is hiring a financial navigator who can provide patients with a roadmap of the expenses related to their care. In a study of just 4 hospitals using financial navigation services, $39 million of financial assistance was procured to support the care of patients and reduce their out-of-pocket expenses.6 These professionals can also help to ensure that a patient’s financial situation does not affect compliance with treatment. In one study, 20% of patients surveyed admitted taking less than the prescribed amount of medication to mitigate drug-related expenses.7 For individuals with cancer, cutting back on life-saving drugs could have devastating results. With the help of trained financial navigators, patients can be supported so that they do not have to compromise on the quality of their care.

Conclusion

The increasing financial burden experienced by patients with cancer can negatively affect clinical outcomes, including those related to quality of life and even survival. To ensure optimal outcomes, oncology providers need to determine how best to assist patients with the cost burden associated with diagnosis and treatment and be prepared to connect them with the resources and professionals necessary throughout the continuum of care.

References

  1. American Cancer Society Cancer Action Network. The costs of cancer: 2020 edition. October 2020. www.fightcancer.org/sites/default/files/National%20Documents/Costs-of-Cancer-2020-10222020.pdf. Accessed October 10, 2021.
  2. Mariotto AB, Enewold L, Zhao J, et al. Medical care costs associated with cancer survivorship in the United States. Cancer Epidemiol Biomarkers Prev. 2020;29:1304-1312.
  3. American Cancer Society Cancer Action Network. COVID-19 pandemic early effects on cancer patients and survivors: April 2020. April 22, 2020. www.fightcancer.org/policy-resources/covid-19-pandemic-early-effects-cancer-patients-and-survivors-april-2020. Accessed October 19, 2021.
  4. American Cancer Society. How we’re providing support. www.cancer.org/about-us/what-we-do/providing-support.html. Accessed October 10, 2021.
  5. Hoadley J, Cubanski J, Neuman T. It pays to shop: variation in out-of-pocket costs for Medicare Part D enrollees in 2016. December 2015. https://files.kff.org/attachment/Issue-Brief-It-Pays-to-Shop-Variation-in-Out-of-Pocket-Costs-for-Medicare-Part-D-Enrollees-in-2016. Accessed October 10, 2021.
  6. Yezefski T, Steelquist J, Watabayashi K, et al. Impact of trained oncology financial navigators on patient out-of-pocket spending. Am J Manag Care. 2018;24(5 Suppl):S74-S79.
  7. Schneider L, Ruller C. Making the business case for hiring a financial navigator. www.accc-cancer.org/docs/projects/financial-advocacy/ufo-2019-fan-navigator-tool.pdf?sfvrsn=66b3d4ba_4. Accessed October 10, 2021.
Article provided through a partnership with
Practice Management Institute
and
Michigan Society of Hematology & Oncology

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