What’s It Gonna Cost, Doc?

Cancer patients often want to talk about the cost of treatment but rarely do

(RxWiki News) Have you ever wondered how much a medical test or procedure is going to cost? Have you wanted to talk to your doctor about costs, but were too afraid or embarrassed bring up the topic? If so, you’re like most Americans.

New research has shown that most cancer patients wanted to know about the costs of their medical care. Yet many patients kept quiet about costs for a variety of reasons.

More than a quarter of the respondents said they did not focus on the cost; they just wanted the very finest care available.

"Research the cost of your medical care."

Researchers at Duke Cancer Institute were led by Yousuf Zafar, MD, MHS, assistant professor at Duke. The study involved some 120 insured cancer patients from around North Carolina.

The researchers wanted to know if costs influenced cancer patients’ treatment decisions.

“We know many patients are burdened by out-of-pocket costs, but we know little about how those costs impact decision making,” Dr. Zafar said in a press release.

dailyRx News asked breast cancer specialist, Adam Brufsky, MD, PhD, professor of medicine at the University of Pittsburgh School of Medicine, if he ever talked about costs with his patients. “I sometimes talk about costs, but mostly how the costs relate to co-payments for the patient on certain tests,” he said.

Dr. Zafar and colleagues found that 48 percent of those surveyed said they would like to talk about finances with their physicians. However, only 21 percent said they actually had such conversations.

Of the people with the most financial distress, 68 percent said they wanted to have these discussions.

When asked why they didn’t initiate these conversations, patients mentioned they would have been embarrassed to bring up the topic. Others said they didn’t think their doctors could help, and the patients didn’t want to cause them to worry about it.

Previous studies have shown that cancer patients have been concerned that talking about costs could possibly impact the quality of care they received.

Interestingly, more than half - 54 percent of cancer patients wanted their doctors to account for costs in treatment decision-making, and 20 percent always wanted costs considered when making decisions about treatment options. 

Of the patients who did have conversations about costs, 48 percent reported that the interactions were positive and that their expenses were reduced as a result of the discussions.

“This suggests that the perceived barriers to the cost conversation aren’t real, and we need to do more to foster a dialogue around these issues,” Dr. Zafar said.

The lead author went on to say that cost considerations need to become a part of the shared decision-making process. "As providers, our team is convinced that cost discussions with our patients is important, and knowing that patients want to have these discussions should give us confidence in making this a routine practice,” he concluded.

Findings from this study will be presented June 3 at the 2013 Annual Meeting of the American Society of Clinical Oncology (ASCO). All research is considered preliminary before it’s published in a peer-reviewed journal.

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Review Date: 
May 23, 2013