Supplements May Lead to Financial, Adherence Issues in Breast Cancer

Supplements, complementary therapies and alternative medicines can be costly for patients with breast cancer, research found.

As many as a quarter of patients with breast cancer face a financial burden due to the high cost of supplements, complementary therapy and alternative medicines, and such burdens have potentially greater affects for different populations of patients, according to data resented at the 2023 American Society of Clinical Oncology (ASCO) Quality Care Symposium.

Additionally, researchers found that the “downstream effects of financial toxicity from tinctures and holistic medicines specifically may decrease adherence to prescribed medications,” and stated in a poster presented at the symposium that “discussion regarding the risks, benefits and costs of supplements, (complimentary therapy) and (alternative medicines) is an essential part of patient-centered cancer education.”

Dietary supplements include “a wide range of products including vitamins and minerals, herbs and other botanicals, amino acids, enzymes and more,” while complementary therapy, like integrative therapy, refers to “many kinds of products and practices that are not part of standard medical care but may be used by people with cancer to better manage cancer-related symptoms and side effects” and alternative medicine “refers to unproven or disproven methods used instead of standard medical treatments to prevent, diagnose, or treat cancer,” according to the American Cancer Society.

Noting that these options “can have high out-of-pocket costs, driving financial toxicity,” researchers evaluated responses from an anonymous survey of breastcancer.org members conducted in June and July of 2022, with 1,437 respondents completing the survey. The median age of respondents was 45 years old, 94% of participants identified as women and 61% identified as non-Hispanic White.

Researchers also found that respondents who reported high out-of-pocket costs due to alternative medicines “were more likely to alter their use of prescribed medication (i.e., skip pills, not fill prescriptions, etc.) to cut costs compared to those who did not report this burden,” and that “those who reported high costs from supplements were more likely to take fewer pills as a cost-cutting measure.”

One quarter (25%) of participants reported high out-of-pocket costs from supplements. Respondents with an annual income of at least $200,000 were less likely than those with an income of under $50,000 a year to report a financial burden due to supplements. Respondents with employer-provided insurance experienced lower burdens than those covered by Medicare, while patients with higher levels of education had higher burdens than those with a high school education or less.

While 18% of respondents reportedly experienced high out-of-pocket costs related to complimentary therapy, self-identified Asian patients and those covered by private insurance experienced less burden due to complimentary therapy than non-Hispanic White patients and those covered by Medicare.

Regarding alternative medicines, 18% also reported high out-of-pocket costs, with patients who were age 46 years old or older and patients with an income of at least $200,000 being less burdened. Patients covered by Medicaid were more burdened than those covered by Medicare.

The National Cancer Institute (NCI) advises that patients with cancer speak with their care team if they are considering using what they describe as complimentary and alternative medicine (CAM).

“This is an important step because things that seem safe could be harmful or even interfere with your cancer treatment,” the NCI states on its website. “It's also a good idea to learn if the therapy you're thinking about has been proven to do what it claims to do.”

Suggested questions, according to the NCI, include inquiring about types of complimentary and alternative medicines might help patients reduce stress and anxiety, feel less fatigued, better deal with symptoms and side effects and sleep better.

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