The urgent issue in self-paid cancer treatment: patient burden solutions through the lens of "financial toxicity"

Financial toxicity refers to the stress and burden patients face during treatment because of high treatment costs — a serious problem that has drawn widespread attention. In recent years, as medical technology advances, more and more treatment options have emerged, yet their steep costs have become a grave problem for many patients and families. Financial toxicity not only affects patients' treatment outcomes and quality of life; it can also undermine their adherence to treatment.

Research published in JAMA Oncology found that among cancer patients receiving chemotherapy, the incidence of financial toxicity ran as high as 42.4%. The study also found that financial toxicity negatively affects patients' treatment, including reduced adherence, delayed treatment and diminished quality of life.

A 2018 study, "Medical Financial Hardship Among Cancer Survivors in the United States," found that 25.3% of cancer survivors in the US reported experiencing severe medical financial hardship in the past year.

A joint report by the Cancer Support Community and The Samfund found that more than 60% of cancer patients experienced financial hardship during or after treatment, with over half falling into debt because of treatment costs. It is also common for patients to be unable to afford their medications during treatment due to financial pressure.

Separately, NIH (National Institutes of Health) research found that financial toxicity influences patients' choice of treatment. Some patients may deviate from recommended treatment guidelines to cut costs, or interrupt treatment midway to save on expenses.

Success stories in tackling financial toxicity

A study published in The Oncologist found that using digital technology helps alleviate financial toxicity. In other research, investigators established a Financial Navigation Program to help patients better understand their medical costs and access relevant resources and support.

The program has three goals:

1. Help patients estimate treatment costs, including drugs, consultations and hospitalization. Knowing in advance what they will have to pay allows patients to plan their finances better.

2. Provide information about health insurance and medical assistance, so patients can learn how to obtain additional support and aid.

3. The program also offers a forum where patients can share experiences and information with others, and gain further support and advice.

Among study participants, patients who took part in financial navigation felt the program improved their understanding of their treatment and equipped them with more knowledge about treatment costs, giving them greater confidence in facing the financial challenges ahead.

Another study found that smartphone apps can better track patients' medication-taking behavior and help monitor treatment progress. This information helps patients and physicians manage treatment costs more effectively and reduce the incidence of financial toxicity.

Learning from abroad, landing in Taiwan

Within PatientsForce's patient assistance care system, we have launched a localized "drug cost estimation system, integrated resource service system and medical-financial consultation service", drawing on successful models from abroad so that patients in Taiwan can use digital technology to better understand their treatment costs and access resource information with ease. Better still, by introducing the overseas "treat-first-pay-later" model, we help patients extend their fundraising timeline beyond existing resources — so they can pursue treatment while maintaining their quality of life.

What role do pharmaceutical companies play in financial toxicity?

For patients, treatment costs are among the heaviest burdens of the treatment journey, and financial toxicity can lead patients to abandon treatment altogether. Pharmaceutical companies can therefore help address financial toxicity in several ways:

1. Drug-cost patient support programs: design subsidy schemes across the medication cycle to lower patients' out-of-pocket share and reduce their burden.

2. Patient-centered financial support programs: offer patients deferral options or interest subsidies on installment payments of drug costs, easing the pressure of paying large drug bills in a single lump sum.

3. Patient financial planning capability programs: use digital technology solutions to support clinical care and help patients better understand and manage medical costs and resources, take charge of drug cost planning, and get through the financial hardships of treatment.

Used in combination, these solutions can help pharmaceutical companies lighten patients' financial burden and sharpen their products' market competitiveness, while also strengthening the companies' image and trust in patients' eyes — creating a three-way win for healthcare.