What Factors Can Contribute to Financial Toxicity in Cancer Care?

1. Direct costs

Direct costs include costs for therapy and medications. Prices have soared in recent years, especially with the emergence of newer therapies such as targeted therapies and immunotherapy. Due to rising costs, insurance companies have made changes such as:

• Increased deductibles
• Restricted specialty medication plans
• Higher copayments

As a result, people with cancer may need to pay more out-of-pocket even years after the initial diagnosis.

2. Indirect costs

Apart from medical costs, several other factors can contribute to financial toxicity in people with cancer. These include:

• Loss of productivity at work, which can include:
  • Fewer hours of work
  • Days off work
  • Job loss due to poor health
• Reduced income and assets
• No nonretirement or other savings
• Existing debts
• Out-of-pocket costs as a percentage of income
• Trouble paying medical bills and necessities (e.g., housing, food)
• Bankruptcy

Many patients with cancer report being stressed about paying for the medical bills.

Not all people with cancer are affected by cancer treatment the same way. Those who are at higher risk of financial toxicity and burden due to cancer care include the following: 

• Low-income
• Uninsured 
• Minorities
• Younger people, due to fewer assets and college debt
• Patients who require intensive treatment

Cancer care and treatment can be financially catastrophic to the patients, leading to:

• Decreased quality of life
• Stress, depression, and anxiety
• Reduced spending on food and clothing
• Reduced frequency of taking prescribed medication

Some ways to reduce financial toxicity include:

• Having adequate health insurance
• Discussing your income level with your surgeon or doctor
• Maximizing disability benefits or paid family leave benefits