Cancer’s Financial Burden Being Felt Worldwide

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According to commentary published in the Canadian Medical Association Journal,¹ an estimated 33%–40% of patients in Canada have reported experiencing some sort of financial distress following a cancer diagnosis, whether it involves having to drain their savings, concerning themselves over mortgage payments, and going back to work earlier than actually being ready.

These types of stressors are often related to financial toxicity, which, according to the commentary’s authors, “refers to the direct, indirect and emotional costs to patients following a cancer diagnosis,” and “is increasingly recognized as a risk factor for poor health and cancer outcomes.”

Canada only represents a microcosm of the bigger picture, as in reality, financial toxicity from cancer is being experienced worldwide. Even in nations that offer universal healthcare, where each person is supposed to be provided coverage, while some might be funded by the government, others require that patients buy their own private health insurance,² so there are still associated costs.

“People in Canada can use private insurance plans, provincial catastrophic drug funding programs, and support programs offered by drug companies to pay for unfunded cancer drugs. However, only 60% of people in Canada have private health insurance; these often have maximum payouts, require deductibles or copays, and have complicated and lengthy application procedures,” the study authors wrote. “Thus, many patients with cancer bear partial or full costs of medication. Take-home cancer drugs that are not funded by provincial health care cost $6000 per month, on average. This lack of coverage may become an increasingly important issue, given that half of emerging cancer drugs are for take-home use.”¹

In order to combat this cancer-related financial toxicity, one potential solution could be an update to the federal and local policies pertaining to homecare and medical equipment costs. As it currently stands, the funding of home services is at the will of local health authorities, which in many cases, ends up getting passed down to cancer patients and their families.

A private insurance plan—oftentimes paid at least partially by an employer—could very well fund these services, but if cancer patients find themselves needing to reduce their working hours or even leave this position, there is the chance of also losing coverage as a result.

“Alongside potential drug, equipment, and home care costs, a cancer diagnosis may be accompanied by loss of employment or reduction in income, as well as increased costs related to travel and accommodation for treatment, home modifications, and child care,” the study authors wrote. “On average, self-employed and employed patients with cancer experience reductions in earnings of 43% and 24% in the first year after diagnosis, respectively.”¹

Other possible solutions for alleviating financial toxicity include:

• Cancer care centers with social workers.
• Complimentary or discounted transportation to and from care centers, which could help save on out-of-pocket costs, especially if needing radiation.
• Navigation services, which could help patients using platforms for cancer support funds, disability and sickness benefits, or emotional support programs.

Public benefit programs, including navigation services, which have shown effectiveness in decreasing financial-related burden for patients in United Kingdom.

Overall, the authors concluded that "People on low incomes are at greatest risk of financial burden and related consequences, including poorer health outcomes. Calls for health system innovation and transformation must not overlook the need for supports to manage the financial burden of cancer for patients and their families."

References

1. Wood TF, Murphy RA. Tackling financial toxicity related to cancer care in Canada. CMAJ. March 11, 2024;196 (9) E297-E298; DOI: https://doi.org/10.1503/cmaj.230677

2. Montgomery K. Single-Payer Healthcare vs. Universal Coverage. Verywell Health. August 27, 2023. https://www.verywellhealth.com/difference-between-universal-coverage-and-single-payer-system-1738546#:~:text=Universal%20coverage%20refers%20to%20a,million%20people%20in%20the%20U.S.