Article: Coping with the financial burden of breast cancer


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U.S. News & World Report recently talked to three breast cancer survivors, including two young women, about how they handled out-of-pocket costs and other medical expenses after their cancer diagnosis. (Posted 1/4/18)

Contents

Becoming your own advocate Questions to ask your doctor
You are not alone                             Clinical trials          
What does this mean for me? Resources and references

Many medical and emotional challenges must be faced after a cancer diagnosis, but the financial burden on a patient is often not anticipated and can have severe consequences. Even for those with insurance, the out-of-pocket costs associated with cancer treatment can keep survivors from the medical care they need, including missed follow-up visits and potentially lifesaving medications.

In October 2017, U.S. News & World Report published an article entitled “The Financial Cost of Breast Cancer.” The author, Susan Johnston Taylor, interviewed three cancer survivors (two were under age 40 at diagnosis) who shared their experiences and tips for shouldering the financial burden of cancer. 

Becoming Your Own Best Advocate

An important issue shared by one of the young women involved fertility preservation. Melissa Thompson, then age 32, received her stage 3 breast cancer diagnosis five weeks after giving birth to her first child. She had to decide the next day if she wanted to freeze her eggs so that she could potentially have more children. Initially, her health insurance pre-authorized the fertility treatment, but days before Thompson’s egg retrieval, the insurance company reversed their decision, forcing her to pay the entire $12,085 bill on her credit card. The experience pushed her to advocate to change state insurance laws. "On June 20, 2017, Connecticut became the first state to require insurance coverage for fertility preservation," Thompson shared. Melissa's Law for Fertility Preservation also passed in Rhode Island in July, and Thompson is currently working to get the policy passed in other states.

You Are Not Alone

Even people with health insurance coverage can face a medical financial burden. Most patients see multiple specialists monthly, if not weekly.  Out-of-pocket costs, like co-pays and deductibles can therefore add up very quickly. Prescription drug costs can be significant as well. After her breast cancer diagnosis, Marianne Small shared that she was lucky enough to connect with a local cancer support group, where she learned about local and national resources like Meals on Wheels and prescription drug savings programs like FamilyWize that can relieve some of a patient’s financial burden.

Recognizing the Long-term Burden

Another young survivor interviewed in this article was Hannah Martine, a single professional who struggled with treatment-related costs after her Stage 4 diagnosis. She had insurance through her employer, and she had no choice but to continue working during treatment.  Hannah ultimately had to make a choice to leave her career to go on short-term disability. However, with a stage 4 diagnosis, even years after her initial diagnosis she continues to have significant out-of-pocket costs. Like others, Martine stresses the importance of reaching out for help, even close to home. She suggests that family and friends help with filling out paperwork or making phone calls. Martine was able to work with the cancer care coordinator at her hospital who helped her to identify helpful programs, like free meal delivery service. Jewish Family Services and other organizations provide financial assistance; Hope for Young Adults with Cancer, for example, is a nonprofit that helps patients between the ages of 18 and 40.

What does this mean for me?

The challenges and experiences shared by these three women highlight the financial burden faced by patients at that critical time after a diagnosis and in the years that follow. As a patient, it’s important to realize that you are not alone. By discussing insurance, money, support and other concerns with your health care provider, you can access patient assistance programs and/or generic drugs, assistance with insurance appeals, and referral to organizations that may help provide financial assistance and/or support in navigating the health care and health insurance systems. 

FORCE spoke to one of our Scientific Advisory Board members, Dr. Allison Kurian M.D., M.Sc., Associate Professor of Medicine (Oncology) and Health Research and Policy at Stanford University School of Medicine. Dr. Kurian’s research has focused specifically on examining the financial impact on patients’ lives after breast cancer. She agreed with the patient perspectives shared in this media article and stressed, “Recent studies have emphasized that many breast cancer patients face a substantial financial burden. This is an urgent priority for improvement in healthcare and policy”.

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Posted 1/4/18

Questions To Ask Your Health Care Provider

  • How much will my treatment cost?
    Will my insurance cover my treatment costs?

  • Do you work with patient navigators, oncology social workers, or financial counselors who can help me cope with the financial burden of my cancer care?

  • What organizations or patient assistance programs can help provide me with financial assistance?

  • Are there any options or financial arrangements that will allow me to pay my treatment costs over time?
  • Are there open clinical trials that are appropriate for me?
  • If alternative treatments are available, what are the benefits, risks and costs of each?

Open Clinical Trials

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