Financial Toxicity

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Patients living with diseases like heart disease, cancer, and other conditions that require expensive treatments and frequent hospitalizations are often suffering from the additional side effect of financial toxicity. This effect can diminish quality of life, and prevent the patient from obtaining the highest quality of care. It often results in these patients who need care the most skipping medications or appointments. Patients may also forgo other needs in order to pay for medical treatment. Financial distress may even increase mortality.

In low income patients with chronic atherosclerotic heart disease, one in four patients had medical expenses that exceeded 20% of their family’s annual income. For one in ten of these patients, the cost of care was over 40% of their income. More here

About 20 % of older patients with cancer experience financial toxicity. These patients also have a higher prevalence of severe anxiety and depression, and a poorer quality of life.  More here

Cancer patients who file for bankruptcy have a 79% greater risk of early mortality than patients who do not. Patients are often willing to go broke to get treatments that offer limited or even nonexistent benefits. Desperate situations often lead to desperate measures being taken.

High out-of-pocket costs are mostly seen in patients with private insurance. High premiums, deductibles and copayments all contribute to financial toxicity.

In spite of the substantial burden on their patients, many providers still do not discuss financial issues with their patients. This is a difficult conversation to have with patients, and one that health care providers are not adequately trained for. In addition, providers may not have knowledge of or access to resources that may provide financial help.

The solution to the problem of financial toxicity is probably a job for elected officials, but patients and providers alike must do better to communicate and deal with these issues as they arise.

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