By the Numbers: Out-Of-Pocket Costs for Cancer Treatment

Filed Under: Costs, Health reform

Today’s number: $1,266

That’s the average cancer patients pay out-of-pocket every month for their care, according to a new study out of the Duke University Medical Center. (For you nerds, the mean among patients was about $700). Those polled were, on average, about 64 years old. All were insured, either privately, through Medicare, or both. Most of their uncovered expenses–41 percent–come from prescription drugs, though medical equipment, travel, special diet and non-prescription drugs also were  factors.

Patients reported the out-of-pocket costs forced them to cut back not only on dining out and trips to the movies, but also on food and clothing. It affected their care, too. Some didn’t fill prescriptions, others skipped prescribed medicine and (not surprisingly)  whittled down their savings or went into debt in order to make ends meet. Nearly half of those polled saw the financial impact of these out-of-pocket costs as “significant or catastrophic.”

“I have had to go without groceries in the house just to get my medicine,” said one patient in the survey. Another wrote, “My parents pay my medical bills which is humiliating when I worked 27 years as a teacher.” For some, costs brought shame on top of the high dollar signs. For another patients, they brought homelessness.

While the average patient without cancer may not face quite such heavy burdens, many of us find ourselves reaching into our pockets to cover medical expenses. The researchers’ takeaways, published this week on Kaiser Health News, offer suggestions to both doctors and patients with and without cancer:

Patients should take the initiative to describe their experiences with doctors and should not hesitate to initiate a discussion about the potential cost of care, with an understanding that being mindful of expenses does not necessarily preclude the highest quality care. For their part, physicians must be open to discussing the cost of care at the bedside. Data suggest that physicians are uncomfortable discussing health care expenses, possibly because of a lack of time, perceived lack of solutions and a fear that advocating for less expensive care might compromise the quality of care a patient receives. But this discussion should play an important role in the medical decision-making process.A simple question like, “Do you have prescription drug coverage?” might save a patient thousands of dollars over the course of treatment.

Finally, policymakers must recognize the impact of cost sharing on the financial burden carried by patients. Insurance providers are shifting more of the costs of cancer care to patients, and patients are decreasing the amount of care for which they are willing to pay. We can only wonder if, in the long term, this incomplete care will increase the overall cost to the health system.

The Takeaway: Talk to your doctor about your insurance status. If a procedure or a pill is financially burdensome, see if there are other good options. Health providers may themselves hesitate to ask, but if you let them know the collateral costs of your care, you may be able to find a better, cheaper, solution.

This is the first post in an occasional series in which we pluck a number from current research, news reports, advertisements and public disclosures to see what it tell us about the health-care marketplace. Do you have a number? Let us know: info [at] clearhealthcosts [dot] com

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