Cancer patients paid $21 billion for care and treatment in 2019 in the U.S., with many reporting increasing financial hardship related to their care, according to a report published October 26 in the Journal of the National Cancer Institute.
This total includes patient out-of-pocket payments of $16.2 billion and time costs of $5 billion -- with time costs consisting of travel to and from appointments, waiting to be seen, and receiving care, wrote a team led by K. Robin Yabroff, PhD, of the American Cancer Society in Kennesaw, GA.
"Medical financial hardship is increasingly common, with many cancer survivors reporting difficulty paying medical bills, high levels of financial distress, and delaying care or forgoing care altogether because of cost," the group noted.
The report is a collaboration between the American Cancer Society, the U.S. Centers for Disease Control and Prevention (CDC), the U.S. National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). Part 1 was published in July and described national cancer statistics. This second part focuses on the economic burden cancer places on patients.
Expensive to treat
Cancer has long been one of the most expensive diseases to treat, and costs have increased in the past few years as treatments have advanced to include targeted therapy, immunotherapy, advanced imaging, and supportive care, said NCI director Dr. Norman Sharpless in a statement released by the institute.
"In the modern era of cancer research, we have to think about treatment costs and how they impact our patients. As exciting and promising as cancer research is, we are keenly aware of the issue of financial toxicity for these patients," he said "Therapies that are highly effective are no doubt good news, but if they are unaffordable, it is not the total kind of progress we would like to see."
For this study, Yabroff's group included data from 2000 to 2013 drawn from the Surveillance, Epidemiology, and End Results (SEER) registry and 2008 to 2017 data from the Medical Expenditure Panel Survey.
The investigators found the following:
- Annual net out-of-pocket costs for medical services and prescriptions were highest among adults 65 and older in the initial and end-of-life stages of the disease ($2,200 and $3,823).
- Out-of-pocket costs were higher for patients diagnosed with more advanced cancer.
- Annual net time costs due to cancer were $304 for adults between 18 and 64 and $279 for those 65 and older; time cost was higher in patients more recently diagnosed.
The group also discovered that patient costs were higher for more prevalent cancers, such as breast ($3.1 billion), prostate ($2.3 billion), colorectal ($1.5 billion), and lung ($1.4 billion).
The study results underscore how important it is to confront any medical hardship patients face, said ACS CEO Karen Knudsen, PhD, in the NCI statement.
"As the costs of cancer treatment continue to rise, greater attention to addressing patient medical financial hardship, including difficulty paying medical bills, high levels of financial distress, and delaying care or forgoing care altogether because of cost, is warranted," she said. "These findings can help inform efforts to minimize the patient economic burden of cancer, and specific estimates may be useful in studies of the cost-effectiveness of interventions related to cancer prevention, diagnosis, treatment, and survivorship care."
