Oncologists Need to Discuss the Costs of Cancer Care

Besides the emphasis on personalized medicine at this year's ASCO Meeting, there is also a focus on addressing the rising costs of administering cancer care, which are currently increasing at a rate of 15% annually. Newer agents can cost thousands of dollars monthly, and many patients with cancer are unfamiliar with having to make trade-offs between very high out-of-pocket costs and expensive treatments that have modest but measurable health benefits. In a session that examined the rising costs of healthcare, Neal J. Meropol, MD, director of the gastrointestinal cancer and gastrointestinal tumor risk assessment programs at Fox Chase Cancer Center, noted “As physicians, we have a responsibility to understand the impact that the increasing costs of cancer care has on everyone involved. In particular, we need to be able to discuss with our patients the impact that high out-of-pocket expenses might have on them and their families, however difficult that conversation might be.” Indeed, the conversation is difficult, and a survey of 167 medical oncologists, which was published in the Journal of Clinical Oncology in 2007, found that only 37% of oncologists always discussed costs with their patients, and an astounding 31% never brought it up.

In response to the growing challenges surrounding the cost of cancer care, ASCO has developed several practical educational tools and resources to assist oncologists in discussing the cost of care with patients through its Cost of Care Task Force. One of these resources is a patient guide on managing the costs of care, which can be accessed at www.cancer.net/managingcostofcare and provides an overview about the financial costs of cancer care in the United States and why patients should talk openly about them with their health care team. It also reviews the medical costs and nonmedical expenses that can accumulate during treatment and recovery and provides a list of questions that can help patients initiate discussions about the costs they may incur. Additionally, there are lists of organizations that can offer help for patients with cancer facing financial challenges, as well as overviews of the different types of health insurance and tips on organizing the financial paperwork that comes with a cancer diagnosis. There is even a glossary that defines some of the common terms and acronyms related to the costs of cancer care.