Medical bills force cancer patients to skimp on care and necessities

June 7, 2011 in Cancer

(Medical Xpress) -- Even when covered by health insurance, cancer patients face mounting out-of-pocket expenses that force some to avoid filling prescriptions, skip doctor appointments, and scale back on food and other necessities.

The findings by researchers at Duke University Medical Center and Dana-Farber Cancer Institute were reported Monday (June 6, 2011) at the annual meeting of the . They highlight the that underlie current about , , and escalating health care costs.

"Overall, this study provides a patient–centered view of a reality of modern day cancer care -- something that we call 'financial toxicity,'" said Dr. Amy Abernethy, associate professor in the division of medical oncology at Duke and senior author of the study.

"We used to think about chemotherapy toxicity in terms of bad side effects like vomiting, nerve pain, confusion, and risk of fatal infection," Abernethy said. "Now we are starting to think in terms of how treatment choices impact real aspects of daily living such as the ability to buy groceries or not."

The research team surveyed 216 patients, some treated at Duke and others from around the country who sought help paying for their cancer care through the HealthWell Foundation, a national nonprofit that helps underinsured patients afford high-cost medications. The foundation sponsored the study.

Most of the study participants were women (88 percent) battling breast cancer (76 percent). All but one participant had insurance, with two-thirds of the study group covered by Medicare; 83 percent also had prescription drug coverage.

Yet even with , out-of-pocket expenses averaged $712 a month for doctor visit co-pays, prescription medicines, lost wages, travel to appointments, and other expenses.

Such expenses presented a significant burden to 30 percent of study participants and a catastrophic problem for 11 percent.

"I became homeless and our entire family has had to live with a friend several times," one patient wrote to the study authors. Others noted they went without groceries to pay for medicines.

"My parents pay my medical bills, which is humiliating when I worked 27 years as a teacher," another patient wrote.

Yousuf Zafar, MD, MHS, lead author of the study, said such financial burdens affected treatment choices as well. Zafar said patients reported not filling , rationing medications, skipping treatment appointments, and opting out of recommended tests.

"These expenses are impacting health care because patients are not spending money on the care their doctors believe they need," Zafar said.

He said the Duke study did not directly explore whether the patients suffered worse outcomes as a result of the treatment choices imposed by their financial burdens.

But the study did find that patients were less satisfied with their care when out-of-pocket expenses created hardship, and that patients were taking fewer medications due to costs.

"Increasingly what insurers and payers are doing is sharing costs with patients in the belief that the patient will be motivated to drive down expenses for unneeded or unwanted care," said Jeffrey Peppercorn, MD, MPH, associate professor of medicine at Duke and a study co-author.

Peppercorn, who serves as chief ethics advisor for HealthWell Foundation, said the study indicates that cost-shifting often adds hardship to people already facing challenges.

HealthWell Foundation is a nonprofit association established in 2004 to provide financial assistance for prescription drug coinsurance, copayments and deductibles, health insurance premiums, and other out-of-pocket health care costs.

Provided by Duke University search and more info website

5 /5 (1 vote)  

Rank 5 /5 (1 vote)
Relevant PhysicsForums posts

More news stories

Small cancer risk following CT scans in childhood and adolescence confirmed

The gap between life expectancy in patients with a mental illness and the general population has widened since 1985 and efforts to reduce this gap should focus on improving physical health, suggest researchers in a paper ...

Cancer created 4 hours ago | popularity not rated yet | comments 0

Changing cancer's environment to halt its spread

By studying the roles two proteins, thrombospondin-1 and prosaposin, play in discouraging cancer metastasis, a trans-Atlantic research team has identified a five-amino acid fragment of prosaposin that significantly reduces ...

Cancer created 5 hours ago | popularity not rated yet | comments 0

Novel RNA-based classification system for colorectal cancer

A novel transcriptome-based classification of colon cancer that improves the current disease stratification based on clinicopathological variables and common DNA markers is presented in a study published in PLOS Medicine this w ...

Cancer created 6 hours ago | popularity not rated yet | comments 0

Low radiation scans help identify cancer in earliest stages

A study of veterans at high risk for developing lung cancer shows that low-dose computed tomography (LDCT) can be highly effective in helping clinicians spot tiny lung nodules which, in a small number of patients, may indicate ...

Cancer created 7 hours ago | popularity not rated yet | comments 0

Poliovirus vaccine trial shows early promise for recurrent glioblastoma

An attack on glioblastoma brain tumor cells that uses a modified poliovirus is showing encouraging results in an early study to establish the proper dose level, researchers at Duke Cancer Institute report.

Cancer created 9 hours ago | popularity not rated yet | comments 0


If you can remember it, you can remember it wrong

(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...

B vitamins could delay dementia

(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...

New sleeping pill poised to hit US markets

An experimental sleeping pill from US drug company Merck is effective at helping people fall and stay asleep, according to reviewers at the US Food and Drug Administration, which could soon approve the new drug.

Reducing caloric intake delays nerve cell loss

Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...

Insight into the dazzling impact of insulin in cells

Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.

Antidepressant reduces stress-induced heart condition

A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.