The Financial Toxicity of Cancer Treatment

Cancer drugs are essential for people with cancer. These drugs can help some live longer without the cancer spreading. However, these drugs come with a high price tag. This can cause a lot of financial stress for the person with cancer and their family.¹

And the pain does not stop with cancer drugs. Other costs add up quickly, like:^1-4

• Paying for parking at facilities
• Eating out when away from home
• Traveling back and forth for appointments
• Medical devices not covered by insurance

Financial toxicity is a term cancer doctors use to talk about the negative impact of cancer care on a person's financial status. This can include increased costs related to diagnosis, treatment, follow-up care, lost income, and increased debt. Financial toxicity may be acute (short-term) or chronic (over time).²

Who is at risk?

People with cancer and their families are at risk of experiencing financial toxicity related to cancer care. This includes people with all types of cancer, regardless of the stage of their disease or the variety of therapies they receive. However, some things may put people at a greater risk of financial distress, including:^1,3

• Type of cancer
• Age
• Insurance status
• Income and job status

Type of cancer

Cancers that are more likely to require expensive drugs, devices, or procedures are more likely to cause a financial burden. For example, a single pill can treat some cancers. Others require expensive drugs, surgery, radiation, and other therapies.¹

Age

Older adults are at a greater risk of financial toxicity in cancer treatment because they are more likely to have other health problems that require treatment. They may also be retired or on a fixed income, making it difficult to pay for additional medical expenses.²

Insurance status

People who do not have health insurance or have inadequate health insurance are at high risk of financial distress.^1-3

Income and job status

People who were unemployed or had a low income before their cancer diagnosis are at a greater risk of financial problems. They may have difficulty paying for their cancer care and other related expenses. This is because they often have the least amount of money saved up to cover treatment costs. They may also have a hard time returning to work after their treatment is finished.^1-3

​​Many low-income workers in the United States have to work in difficult or unsupported conditions. They often do not have access to the same workplace accommodations as other workers.

For example, only 21 percent of workers whose earnings are in the lowest 10 percent of incomes nationwide receive paid sick leave. Therefore, those who cannot afford to lose their jobs are at the highest risk of losing them.²

Signs of financial toxicity

The signs of financial distress can vary from person to person. Some people may experience only a few of these signs, while others may experience many.¹

Difficulty paying for medical expenses

One of the most common signs is having difficulty paying for medical expenses. This can include the cost of therapies, drugs, doctor's visits, and other related costs.^1,3

Increased debt

Another common sign of financial hardship is increased debt. This can be from credit cards, loans, or other sources. The use of savings, selling your valuables, borrowing money, or carrying credit card debt are some lifestyle choices that might lead to serious financial problems.^1-3

Problems at work

Cancer treatment can also cause problems at work. This can include difficulty keeping up with work, missing work, or being unable to work.^1-3

Changes in lifestyle

Paying for cancer care can also lead to changes in lifestyle. This can include changes in diet, exercise, and other activities. If the person's household has a lot of medical bills, they may have to reduce how much they spend on other things. Some may skip appointments or doses of drugs, which can have a bigger impact on their health.^1-3

Emotional distress

Paying medical bills can take a toll on your emotions. Anxiety, depression, and stress can all occur as a result. When coupled with the already stressful situation of a cancer diagnosis, medical bills can be overwhelming.¹

Tips to prevent or relieve financial distress

Several steps can be taken to help reduce the impact of financial strain. An important first step is to understand costs related to your medical care, such as:⁴

• Where you live
• The hospital you go to
• The insurance you have
• Childcare needs
• Parking and travel expenses
• Other out-of-pocket costs

Many places have payment options available to help manage healthcare expenses. Some of these programs include:⁴

• Drug co-pay programs
• Payment plans
• Charities and nonprofits

Hospital social workers are experts that can help you get the resources you need.⁴

Know your health insurance

When you are diagnosed with cancer, it is crucial to understand your medical insurance and the coverage it provides for you. This includes:⁴

• How to pay a bill
• Costs of services
• Out-of-pocket expenses
• Steps to take if treatment is denied
• How to request a case manager

Managing your finances can be difficult when you are battling cancer. You can take some steps to help ease the financial strain, including speaking with your healthcare team about financial assistance programs and looking into whether your health insurance plan covers the cost of cancer drugs and treatments.⁴

Financial strain can add to the emotional exhaustion of a cancer diagnosis. But taking some of the steps listed above might help you reduce your financial worry and focus on your treatment.¹