As the cost of cancer care increases, patients are shouldering a huge economic burden. Patient out-of-pocket (OOP) and time costs reached over $21 billion in 2019, according to a new report from the National Cancer Institute (NCI), American Cancer Society, CDC, and the North American Association of Central Cancer Registries.
Cancer patients face billions in out-of-pocket and time costs for care
According to the report, cancer patients are facing increasingly high costs of care through higher deductibles, copayments, and coinsurance. In addition, patients experience substantial time costs as they travel, wait for, and receive care, which can lead to further economic burdens.
To estimate the OOP and time costs associated with cancer care among adults, researchers analyzed data from Surveillance, Epidemiology, and End Results (SEER) Medicare database and the Medical Expenditure Panel Survey (MEPS).
Overall, the researchers found that the national patient economic burden of cancer care was $21.09 billion. Of this, $16.22 billion was from OOP costs, and $4.87 billion was from patient time costs.
The researchers also saw significant variations in economic burden by cancer type, reflecting differences in treatment intensity, duration, and survival. In 2019, cancers with higher prevalence had the highest national OOP costs, including:
- Breast: $3.14 billion
- Prostate: $2.26 billion
- Colorectal: $1.46 billion
- Lung: $1.35 billion
In addition, the researchers found that cancer patients under 65 paid more in OOP and time costs than patients ages 65 and older. In the first year of diagnosis, the average OOP cost was $2,700 and the average time cost was $279.10 for patients ages 65 and older. In comparison, patients ages 18 to 64 paid an average of $5,900 in OOP costs and $304.30 in time costs in their first year of diagnosis.
"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," said Karen Knudsen, CEO of the American Cancer Society. "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."
Separately, Norman Sharpless, director of NCI, said, "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 added, "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. Finding ways to ensure that not just some, but all, patients get access to therapies that are beneficial to them is an important goal we must continue to strive for in the cancer community. This report will help guide us toward achieving that goal.”
According to the Washington Post, health officials also noted that prevention could help alleviate the financial burden of cancer care for many patients.
"The cost of having cancer is enormous and an extreme burden on people and families, particularly for those who are uninsured or underinsured," said Karen Hacker, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. "Prevention is key to lowering out-of-pocket costs. ... Access to the right cancer screening tests at the right time is an important step toward health equity, and we must work to make this a reality." (Blakemore, Washington Post, 10/30; Inserro, American Journal of Managed Care, 10/29; Yabroff et al., Journal of the National Cancer Institute, 10/26; National Cancer Institute news release, 10/26)