A cancer diagnosis can be a “catastrophic event,” according to Dr. Greg Knight of the Levine Cancer Institute in Charlotte, North Carolina.
The disease itself is terrifying to face; however, Knight says patients are avoiding the reality because they are unsure how they will be able to afford treatments, medications and the impact the disease has on day-to-day life.
This week on “Take Care,” Knight, a clinical oncologist, shares the findings of his group’s study, titled “Financial Toxicity in Adults with Cancer, Adverse Outcomes and Potential,” as well as how the costs have changed and how patients can approach paying those costs.
The problem of financing treatment has been recognized for a long time, according to Knight. His group did the first major study in 2013, testing 2,000 patients who were undergoing active treatment and had been diagnosed more than 90 days before beginning treatment.
Knight says they kept the study simple, asking questions for participants to agree or disagree with, such as “Do you have to pay more for medical care than you can afford?”
The results showed roughly one in four participants said they could not afford their medical care. Some were even saying they could not go to the doctor or fill their prescriptions. Knight believes that these results are representative of the impact nationally.
Knight’s group recognized two concerns when treating cancer were the financial burden on the patients and their families and its impact on patient compliance to treatment.
“The one thing we haven’t really figured out is if you have children or if you’re working and you have a cancer diagnosis and you’re out of work and you need to get to a cancer center to get chemotherapy that is not close to your house,” Knight said.
The time it takes to treat cancer and recover from treatment can be as taxing on a patient as the costs. Knight specializes in treating leukemia and a lot of times his patients are out of work for the first six months of treatment.
Questions begin to swirl about these hidden costs including: How are you going to afford getting off work? Do you have the savings for that? Can you afford to travel somewhere for treatments? Do you even have a car or is it a shared car within your family? Who is going to take care of your children when you’re doing this?
Knight and his colleagues found that these rising pressures were among the reasons why patients would stop coming in for their appointment and/or filling prescriptions.
Knight says that as cancer treatment becomes more specialized, that brings other issues.
“Honestly, it’s like science fiction sometimes what we’re doing with these target antibodies and oral chemotherapeutics and all the new scientific discoveries,” Knight said. “The issue is we’re getting further and further away from have affordable medications.”
The doctor sees the days of generic versions of some of these drugs dwindling, while the generic versions of others could stop manufacturer assistance with costs.
Insurance plans are not always the answer for patients struggling to pay their bills.
Knight says there is usually a well-insured group of patients that can get everything paid for and a group with no insurance that can get assistance with payments through charity care or other types of assistance like it. But, then there is a group left in the middle that is under insured, yet does not qualify for financial assistance programs and cannot afford all their medical bills.
There is no perfect answer to date but the doctor says there are options for financial relief.
“There are a lot of both private and public sources of funding that patients just aren’t aware of and a lot of times doctors aren’t aware of,” Knight said. “For each cancer type, there’s always a society that have grants and other abilities to get money for both the medication and just the social issues that you’re going to have with a cancer diagnosis.”
Also, he says patients can ask either the manufacturer or their doctor about alternative drugs that they may know about that cost less.
And Knight says IV chemotherapy is often a more affordable option than oral chemotherapy, which has become more commonly used in recent years.
