A diagnosis of cancer can affect every aspect of a person’s life. We know that receiving a diagnosis of a rare, life threatening cancer such as malignant mesothelioma, can cause stress for both the patient and the patient’s family. Stress can be caused by many factors, physical, emotional and social. One of the goals of the patient, family and medical team when deciding on treatment is the effect on the person’s quality of life. Is the treatment going to maintain their quality of life? The stress can be significantly increased when the patient and the patient’s family also is worried about money. There are costs associated with treatment that are covered and not covered by private insurance or Medicare. These out of pocket expenses, co-pays for medications, co-pays for doctors’ visits, parking, eating at the facility, hotel rooms, are some of the examples that patients and families have to pay for when being treated for cancer. For some the effect on their personal finances can affect their choice of treatment options and their quality of life.

The cost to a patient’s health, due to the stress of financial problems created during cancer treatments is not something that is being ignored by the health care team. The impact of finances on a patient’s cancer journey is now being studied by many health care researchers. A few facts are listed below:

– The term “financial toxicity” refers to insured out of pocket expenses related to treatment- costs. It has been found that these expenses can diminish quality of life and impede delivery of the highest quality of care. Research has identified both objective financial burden and subjective financial distress as key components of financial toxicity

– The cost of cancer care in the United States for the year 2015 was 107 billion dollars.

– Keytruda – Pembrolizumab is $14,500 per month

– In 2014 cancer patients paid nearly 4 billion out of pocket for cancer treatments- total spending on cancer-related health care 87.8 billion in 2014

– In 2015 Americans spent 284 billion on prescriptions -about 9%- 32.6 billion spent on oncology drugs- another 11.1 billion spent on supportive care treatments which help with the side effects of strong chemotherapy drugs

– Newly approved cancer drugs cost an average of 10,000 dollars per month with some therapies topping 30,000 dollars per month- patients typically pay 20 to 30% out of pocket for drugs-average years supply would cost 24,000 thousand-to 36,000 thousand in addition to health insurance premiums

– Patients report lower quality of life who have financial toxicity- studies show that patients with cancer who file for bankruptcy may be more likely to die than those who do not file

– Financial difficulties that stem from dealing with cancer have an effect on people avoiding or delaying treatments, care or drugs- can lead to stress that can lead to mental and physical health problems

– 2013 study in the Oncologist found nearly half of cancer patients with insurance cut back on their spending on food and clothing or dipped into savings to pay for treatment

– Patients that have financial difficulty also have increased mental health issues

– A report commissioned by the American Society of Clinical Oncology found 27% of cancer survivors or close relatives of a cancer patient said they skipped doctor visits or had taken other steps to reduce health costs

Some of the ways that the medical system is attempting to help patients deal with this reality is trying to identify patients and screen cancer patients for financial stress. There are navigators in most hospitals that specialize in health insurance plans, and are knowledgeable about resources available. Social workers that know the community resources available are included in the health care team. General awareness has also increased to the importance of knowing the patient and his financial concerns.

Mesothelioma patients who have financial issues need to reach out for the resources that are available to them. It is vital that they use their energy to deal with their serious health challenge, and not be drained by financial concerns.

Sources:

• U.S. News and World Report-by LacieGlover www.usnews.com/topics- July 1,2015
• www.nerdwallet.com/blog/health/2015/06/23/behind-health-insurance- premiums-continue-pay-claims
• www.ncbi.nlm.nih.gov/pmc/articles Financial Toxicity, Part I: A New Name for a Growing Problem S.Yousuf Zafar, MD. MHS and Amy Abenathy MD- financial toxicity the patient level impact on the cost of cancer care
• National Cancer Institute- Financial Toxicity (Financial Distress) and Cancer Treatment www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity
• Web MD- www.webmd.com/cancer/news/20171024/many-cancer-patients-skip-treatments-due-to-cost