The Sticker Shock of Cancer Care

September 11, 2017
Lisa Schulmeister, RN, MN, APRN-BC, FAAN

People being treated for cancer often experience “sticker shock” when they learn what charges they will be responsible for paying and/or when they receive billing invoices.

People being treated for cancer often experience “sticker shock” when they learn what charges they will be responsible for paying and/or when they receive billing invoices.

Proactive conversations about the cost of cancer care is considered good practice. However, little is known about how often these conversations occur.

Researchers led by Wynn Hunter, MD, of Duke University in Durham, North Carolina, examined the content of transcripts from 677 outpatient appointments for breast cancer management.

The patients visited 56 oncologists nationwide from 2010-2013. Cost conversations were identified in 22% of visits and had a median duration of just 33 seconds. These conversations were initiated by oncologists 59% of the time.

In contrast, patients most frequently brought up costs associated with diagnostic testing. About a third (38%) of cost conversations were about cost-reduction strategies, which most commonly sought to lower patient costs for endocrine therapies and symptom management.

The 3 most commonly discussed cost-reduction strategies were switching to a lower-cost therapy, changing intervention logistics, and facilitating co-pay assistance.

The researchers concluded that cost conversations as observed in this study were brief and infrequently mentioned cost-reduction strategies.

The study findings are available here.