Perceptions of health care providers concerning patient and health care provider strategies to limit out-of-pocket costs for cancer care

Abstract

Objective: To describe patients’ and health care providers’ strategies to limit out-of pocket costs for cancer care Setting: Newfoundland & Labrador Methods: Semi-structured interviews with 21 cancer care providers (nurses, social workers, oncologists, surgeons, pharmacists, and dieticians) Results: Patients try to minimize costs by substituting or rationing medications, choosing radical treatments, lengthening the time between follow-up appointments, choosing in-patient care, and working during treatment to minimize loss of income. Providers respond to patients’ financial concerns by helping them access financial assistance programs, changing chemotherapy and supportive drug prescriptions, and/or shortening radiation treatment protocols. They admit patients to hospital and arrange follow-up with physicians closer to the patients’ home. Conclusions: Out-of-pocket costs resulting from cancer care are incurred at all phases of treatment and follow-up. These costs are substantial concerns for some patients and their health care providers. Encouraging communication between patients and their providers is needed to identify individuals at risk and safely modify care plans. Tele-oncology as well as public drug, medical travel and leave programs are needed to ensure that patients are better able to afford costs related to cancer care.