Adopting a proactive patient financial assistance program to mitigate financial toxicity for cancer patients
AI-translated from the Chinese original · editorially reviewed
As healthcare costs rise, expensive cancer drugs have become a major factor, seriously affecting patients' access to care and worsening the inequality of medical resources. In the United States, cancer patients of lower socioeconomic status are more likely to suffer financial hardship, which in turn affects treatment outcomes and quality of life. To address these problems, pharmaceutical companies established Patient Assistance Programs (PAPs). According to the latest research presented this year at the American Society of Clinical Oncology annual meeting (ASCO 2024), PAPs are effective in improving access to drugmaker support and easing financial pressure for uninsured and vulnerable cancer patients.
Socioeconomic status and the financial burden of cancer: current conditions and challenges
In the United States, significant disparities in cancer incidence, survival, morbidity, and mortality persist across different population groups. Compared with individuals of higher socioeconomic status, those of lower socioeconomic status are more likely to bear the burden of cancer and other diseases. Financial hardship is very common among cancer patients. Many cancer survivors report difficulty paying medical bills, bearing heavy economic pressure, and delaying or forgoing care because of cost. These patients are also more likely to experience psychosocial distress. Financial hardship has been shown to negatively affect cancer patients' clinical outcomes, including lower quality of life, increased symptom burden, reduced treatment adherence, and even shortened survival.
A new initiative to promote financial support for cancer patients: an NCI-designated comprehensive cancer center's financial support program
An NCI-designated comprehensive cancer center (NCI-designated CCC) serving a diverse, multilingual population uses the "My Wellness Check" (MWC) program to identify patients experiencing emotional, physical, practical, and social difficulties. Between October 2019 and February 2022, a total of 4,117 patients participated in the MWC survey, accounting for 43.1% of eligible patients. Of these, 801 patients (19.5%) triggered 976 support or practical-need alerts, but only 68.4% of the alerts received a response from a social worker within 72 hours. For patients identified by MWC as facing financial hardship, social workers would find available resources to help cover out-of-pocket costs.
In July 2022, this comprehensive cancer center (CCC) launched a patient financial assistance program, conducting a financial assessment for all patients receiving systemic chemotherapy at its infusion center. The center contracted with a third-party partner (PAP Hub) to provide patient assistance specialists and technology integrated with the electronic health record (EHR). The patient assistance specialists were responsible for identifying eligible patients and enrolling them in the financial support program.
The program's impact on socially vulnerable groups
A retrospective analysis was conducted on the cohort that participated in the patient financial support program between May 2022 and December 2023, compared with the demographic data of infusion center patients. The results showed that the cohort participating in the support program had higher proportions of women, Hispanic patients, patients aged 27–64, patients with commercial insurance, and patients living in areas with high and moderately high Social Vulnerability Index (SVI) scores.
Adopting a proactive patient financial support program can help mitigate the financial distress of cancer patients, particularly those living in areas with high and moderately high Social Vulnerability Index (SVI) scores. Professional collaboration with a third-party partner can not only ease patients' financial pressure in the short term but also help advance more equitable cancer treatment outcomes.