Survey Findings Reveal Financial Challenges in Patients with Cancer

A survey found that high out-of-pocket costs impact access to care, medication adherence and quality of life for patients with cancer, including those on Medicare.

Among patients with cancer, high out-of-pocket costs were found to impact access to health care, adherence to medication, as well as quality of life — even for those on Medicare — according to a national study that is described as "the largest survey yet to examine seriously ill patients receiving charitable copayment assistance".

These findings, which were shared in a news release, show that among the 1,550 respondents of the survey who were from the United States, 31% indicated that they would be unable to afford treatment if they lost their charitable copay assistance. The majority of patients in the study were covered by Medicare. The independent research was published in Cancer, a journal published by the American Cancer Society.

Ninety percent of Medicare recipients reported being “worried” about what would happen if they lost copay assistance, according to findings.

"Many older Americans assume that Medicare will shield them from exorbitant costs if they become seriously ill," principal author of the study, Dr. Jeffrey Peppercorn, said in the news release. "Yet many of the people we surveyed were not aware of the potentially catastrophic cost of care — or that cost could be a barrier to receiving medication prescribed by their doctor for a serious illness like cancer or autoimmune disease."

Peppercorn is an oncologist at Massachusetts General Hospital, as well as an associate professor of medicine at Harvard Medical School, both located in in Boston.

Delving into the Findings

Patients with cancer or serious autoimmune diseases (such as multiple sclerosis) were surveyed for the research and findings showed deep financial distress among participants. The study found that many patients with Medicare delayed essential care due to cost concerns or spent nearly 10% of their income on healthcare expenses, qualifying them as "underinsured." Some patients even skipped medical appointments, scans or X-rays.

Moreover, 37% of study participants reduced their food expenses to manage healthcare costs. Among those surveyed, 53% experienced mild financial distress, and 31% faced moderate to severe financial distress despite receiving charitable copayment assistance.

"The experience of patients needs to be part of the public discussion about charitable copay assistance," said Dr. Suzanne Miller. "This research adds considerably to the still sparse literature describing recipients of charitable copay assistance grants and shows the important role this assistance plays for patients in the American health care system." Dr. Miller serves as the Vice Chair and Secretary to the HealthWell Board.

Miller is an author of the study; a professor of Cancer Prevention and Control; and director of the Patient Empowerment and Decision-Making Department at Fox Chase Cancer Center at Temple University Health System, in Philadelphia, Pennsylvania.

Investigators emphasized that, based on these study findings, copay assistance plays a critical role in the care of many patients with Medicare who have a serious illness, aiding them in the access to necessary, life-saving treatment.

More Information on How the Study Was Conducted

According to the news release, HealthWell grant recipients were surveyed if they consented and met HealthWell's financial eligibility requirements. Of those who responded to the survey, 69% reported annual income of less than $60,000 per year and 42% reported income less than $40,000.

The survey highlights how charitable copay assistance programs help patients with serious illnesses, like cancer, afford their treatments. These nonprofit programs are regulated by the U.S. Department of Health and Human Services and mainly funded by donations from pharmaceutical manufacturers. However, this has led some to worry that the funding may influence overall healthcare costs.

The survey aimed to better understand the experiences of patients receiving this assistance and to help shape future health policies.

"This research shows in a powerful way what we at HealthWell regularly hear from our grant recipients: that without our support they would not be able to pay for the life-sustaining, and often lifesaving, medications they need," Michael Heimall, president and CEO of HealthWell, stated in the news release. "We are a critical safety net for underinsured Americans facing financially and emotionally challenging times."

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