Study results highlight magnitude of financial hardships cancer survivors face

The rapidly rising costs of cancer care in the United States has created a considerable financial burden for many patients and their families.

Matthew P. Banegas, PhD, MPH, a health services researcher with The Kaiser Permanente Center for Health Research, and colleagues sought to assess the proportion of working-age cancer survivors who went into debt or filed for bankruptcy as a result of their cancer care.

Matthew Banegas

Matthew P. Banegas, PhD, MPH

They analyzed data from a 2012 LIVESTRONG online survey of 4,719 cancer survivors aged 18 to 64 years.

Results, published in Health Affairs, showed 33.6% of respondents reported having to borrow money or go into debt to pay for their care. Another 39.7% made other types of financial sacrifices, and 3% filed for bankruptcy.

Survivors who were younger, had lower income or had public health insurance appeared more likely to go into debt or file for bankruptcy.

“Future longitudinal population-based studies are needed to improve our understanding of financial hardship among U.S. working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer,” Banegas and colleagues wrote.

HemOnc Today asked Banegas about the financial effects cancer care can have on patients and their families, as well as the possible ways these challenges can be addressed.

Question: Can you summarize the findings from your study?

Answer: We looked to assess the financial hardship experienced by working-age cancer survivors, and we found that approximately one of every three survivors reported having gone into debt or borrowed money. Among those survivors in debt, more than 50% reported incurring debt of $10,000 or more, and about 10% of this group reported that they had to file for bankruptcy.  What was most surprising to me was the amount of debt that these individuals had incurred. I thought it was a very high amount, and this appears to be a common issue among these patients.

Q: Your study is one of the first to look at the financial repercussions after cancer care among working-age cancer survivors. How is this information useful?

A: There is a growing body of literature, although still small, that addresses this issue. Our study is among the first to focus on working-age cancer survivors. We thought it was important to look into the potentially unique issues that people in this age group may encounter, because they are more likely to be in the workforce and may have challenges related to work. In terms of solutions, there are a few things people diagnosed with cancer and their families can do to lessen the chance of financial hardship. It is important to learn more about the costs of treatment and the care they will need following treatment. They can talk with their physicians or ask their physicians to refer them to someone who is knowledgeable about these costs.  Knowing this information will allow patients and their families to make better decisions about their care, and to find out what financial assistance programs may be available.

Q: Do you foresee an end to the financial hardship of cancer treatment in the near future?

A: In the near future, I believe we will see interventions that try to address this issue. As mentioned before, there is a growing body of scientific literature that highlights this as a common problem for patients diagnosed with cancer. We see stories about the high costs of cancer care in the mainstream media, and society is starting to recognize this as an important issue, but we still need to understand the best time to provide information about financial assistance. It appears that soon after diagnosis is the best time to weigh in with the financial information, but it may be that individuals and their families do not really want to think about the costs or finances at that moment. Most likely, there are a lot of other issues and emotions that these individuals and their families are going through at that time. So, finding this “sweet spot” of when an individual may be most receptive to having discussions about the cost — and then looking for resources and finding ways in which we can help them — is key. I suspect that within the next 5 years, we will have a much better handle on this issue and be that much closer to helping prevent or at least reduce the financial hardship associated with cancer care.    

Q: What do you hope your study will mean for cancer survivors and the health care industry?

A: We hope our study will provide more evidence and information that providers, patients and their families can use to prompt conversations about the costs of cancer care. Ideally, we can all work together to prevent massive debt or bankruptcy from occurring for our patients and our loved ones. Our study highlights the magnitude of this issue and points out what can happen if we do not find a solution. It is our hope to be able to show individuals just how important it is for us all to be informed about the costs of our medical care. – by Jennifer Southall

For more information:

Matthew P. Banegas, PhD, MPH, can be reached at The Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227-1098; email: matthew.p.banegas@kpchr.org.

Disclosure: Banegas reports no relevant financial disclosures.

The rapidly rising costs of cancer care in the United States has created a considerable financial burden for many patients and their families.

Matthew P. Banegas, PhD, MPH, a health services researcher with The Kaiser Permanente Center for Health Research, and colleagues sought to assess the proportion of working-age cancer survivors who went into debt or filed for bankruptcy as a result of their cancer care.

Matthew Banegas

Matthew P. Banegas, PhD, MPH

They analyzed data from a 2012 LIVESTRONG online survey of 4,719 cancer survivors aged 18 to 64 years.

Results, published in Health Affairs, showed 33.6% of respondents reported having to borrow money or go into debt to pay for their care. Another 39.7% made other types of financial sacrifices, and 3% filed for bankruptcy.

Survivors who were younger, had lower income or had public health insurance appeared more likely to go into debt or file for bankruptcy.

“Future longitudinal population-based studies are needed to improve our understanding of financial hardship among U.S. working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer,” Banegas and colleagues wrote.

HemOnc Today asked Banegas about the financial effects cancer care can have on patients and their families, as well as the possible ways these challenges can be addressed.

Question: Can you summarize the findings from your study?

Answer: We looked to assess the financial hardship experienced by working-age cancer survivors, and we found that approximately one of every three survivors reported having gone into debt or borrowed money. Among those survivors in debt, more than 50% reported incurring debt of $10,000 or more, and about 10% of this group reported that they had to file for bankruptcy.  What was most surprising to me was the amount of debt that these individuals had incurred. I thought it was a very high amount, and this appears to be a common issue among these patients.

Q: Your study is one of the first to look at the financial repercussions after cancer care among working-age cancer survivors. How is this information useful?

A: There is a growing body of literature, although still small, that addresses this issue. Our study is among the first to focus on working-age cancer survivors. We thought it was important to look into the potentially unique issues that people in this age group may encounter, because they are more likely to be in the workforce and may have challenges related to work. In terms of solutions, there are a few things people diagnosed with cancer and their families can do to lessen the chance of financial hardship. It is important to learn more about the costs of treatment and the care they will need following treatment. They can talk with their physicians or ask their physicians to refer them to someone who is knowledgeable about these costs.  Knowing this information will allow patients and their families to make better decisions about their care, and to find out what financial assistance programs may be available.

Q: Do you foresee an end to the financial hardship of cancer treatment in the near future?

A: In the near future, I believe we will see interventions that try to address this issue. As mentioned before, there is a growing body of scientific literature that highlights this as a common problem for patients diagnosed with cancer. We see stories about the high costs of cancer care in the mainstream media, and society is starting to recognize this as an important issue, but we still need to understand the best time to provide information about financial assistance. It appears that soon after diagnosis is the best time to weigh in with the financial information, but it may be that individuals and their families do not really want to think about the costs or finances at that moment. Most likely, there are a lot of other issues and emotions that these individuals and their families are going through at that time. So, finding this “sweet spot” of when an individual may be most receptive to having discussions about the cost — and then looking for resources and finding ways in which we can help them — is key. I suspect that within the next 5 years, we will have a much better handle on this issue and be that much closer to helping prevent or at least reduce the financial hardship associated with cancer care.    

Q: What do you hope your study will mean for cancer survivors and the health care industry?

A: We hope our study will provide more evidence and information that providers, patients and their families can use to prompt conversations about the costs of cancer care. Ideally, we can all work together to prevent massive debt or bankruptcy from occurring for our patients and our loved ones. Our study highlights the magnitude of this issue and points out what can happen if we do not find a solution. It is our hope to be able to show individuals just how important it is for us all to be informed about the costs of our medical care. – by Jennifer Southall

For more information:

Matthew P. Banegas, PhD, MPH, can be reached at The Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227-1098; email: matthew.p.banegas@kpchr.org.

Disclosure: Banegas reports no relevant financial disclosures.