More than one-third of cancer patients who carry insurance spend more out-of-pocket for their treatments than they anticipated having to pay. Among those who report being blindsided by the costs of their therapies, the median monthly out-of-pocket expenditure is $703. That surprising financial burden causes distress that sometimes makes them unwilling to pay for the care that could save their lives.
Those are among the sobering findings from a new survey published today by researchers at Duke University in the journal JAMA Oncology. The researchers surveyed 300 patients of the Duke Cancer Institute and three affiliated cancer clinics. The frequent reports of financial distress among these patients, they believe, should be taken seriously by policymakers who are introducing legislation aimed at shoring up the nation’s health care system—particularly now, when the introduction of cutting-edge immunotherapies promises to drive the cost of cancer care even higher.
“The financial toxicity of cancer treatment is impacting patients’ ability to pay for care, and is likely impacting how well they do,” says study co-author S. Yousuf Zafar, associate professor and member at the Duke Cancer Institute.
On average, cancer patients in the Duke study were spending 11% of their household income on expenses related to their treatments. Generally speaking, anyone who devotes more than 10% of their income to health care should be considered underinsured, the authors say.
And patients in the study who reported the most financial distress were spending 30% of their household income on health care. This despite the fact that more than 60% of the people in this group were covered by private insurance. (The others had Medicare or Medicaid.)
“When patients get insurance, more often than not they think their treatments are going to be covered,” Zafar says. “But with insurance design changing, and the increasing in cost sharing over time, just having insurance is usually not enough.”
In fact, the statistics show that insurers and employers are increasingly passing on more costs of health care to consumers in the form of higher premiums and copayments. For example, the average annual premium for family coverage provided…