Ashish Rai1, Zhiyuan Zheng1, Jingxuan Zhao1, Janet S de Moor2, Donatus U Ekwueme3, K Robin Yabroff4. 1. Surveillance and Health Services Research Program, Department of Intramural Research, American Cancer Society, Atlanta, Georgia. 2. Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland. 3. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Surveillance and Health Services Research Program, Department of Intramural Research, American Cancer Society, Atlanta, Georgia. Electronic address: robin.yabroff@cancer.org.
Abstract
INTRODUCTION: Despite the importance of cost-related discussions in cancer care, little is known about the prevalence or drivers of these discussions in clinical practice. This study estimates the prevalence and examines the correlates of cancer survivors' discussions about out-of-pocket costs of cancer care with providers. METHODS: The 2016 and 2017 Medical Expenditure Panel Survey Experiences with Cancer Surveys were used to identify 1,550 survivors who responded to the question on discussion about out-of-pocket costs of cancer care. Multivariable multinomial logistic regression examined the correlates of discussions about out-of-pocket costs. Analyses were performed in 2019. RESULTS: Approximately one quarter of cancer survivors reported having discussed the out-of-pocket costs of cancer care. In multivariable analyses, respondents in the following categories were less likely to report no cost discussion than any cost discussion: black non-Hispanic/other race (RRR=0.67, 95% CI=0.45, 0.98; white non-Hispanic race as reference), no health insurance at diagnosis (RRR=0.51, 95% CI=0.27, 0.95; private health insurance as reference), and any experience of financial hardship (RRR=0.48, 95% CI=0.35, 0.66; no financial hardship as reference). CONCLUSIONS: Patient-reported discussions about out-of-pocket costs for cancer care are infrequent in the U.S. The findings highlight the needs to improve the understanding of the barriers and facilitators for effective discussions about out-of-pocket costs of cancer care.
INTRODUCTION: Despite the importance of cost-related discussions in cancer care, little is known about the prevalence or drivers of these discussions in clinical practice. This study estimates the prevalence and examines the correlates of cancer survivors' discussions about out-of-pocket costs of cancer care with providers. METHODS: The 2016 and 2017 Medical Expenditure Panel Survey Experiences with Cancer Surveys were used to identify 1,550 survivors who responded to the question on discussion about out-of-pocket costs of cancer care. Multivariable multinomial logistic regression examined the correlates of discussions about out-of-pocket costs. Analyses were performed in 2019. RESULTS: Approximately one quarter of cancer survivors reported having discussed the out-of-pocket costs of cancer care. In multivariable analyses, respondents in the following categories were less likely to report no cost discussion than any cost discussion: black non-Hispanic/other race (RRR=0.67, 95% CI=0.45, 0.98; white non-Hispanic race as reference), no health insurance at diagnosis (RRR=0.51, 95% CI=0.27, 0.95; private health insurance as reference), and any experience of financial hardship (RRR=0.48, 95% CI=0.35, 0.66; no financial hardship as reference). CONCLUSIONS: Patient-reported discussions about out-of-pocket costs for cancer care are infrequent in the U.S. The findings highlight the needs to improve the understanding of the barriers and facilitators for effective discussions about out-of-pocket costs of cancer care.
Authors: Alfred I Neugut; Milayna Subar; Elizabeth Ty Wilde; Scott Stratton; Corey H Brouse; Grace Clarke Hillyer; Victor R Grann; Dawn L Hershman Journal: J Clin Oncol Date: 2011-05-23 Impact factor: 44.544
Authors: K Robin Yabroff; Gery P Guy; Donatus U Ekwueme; Timothy McNeel; Heather M Rozjabek; Emily Dowling; Chunyu Li; Katherine S Virgo Journal: Med Care Date: 2014-07 Impact factor: 2.983
Authors: S Yousuf Zafar; Rebecca B McNeil; Catherine M Thomas; Christopher S Lathan; John Z Ayanian; Dawn Provenzale Journal: J Oncol Pract Date: 2014-12-16 Impact factor: 3.840
Authors: S Yousuf Zafar; Fumiko Chino; Peter A Ubel; Christel Rushing; Gregory Samsa; Ivy Altomare; Jonathan Nicolla; Deborah Schrag; James A Tulsky; Amy P Abernethy; Jeffery M Peppercorn Journal: Am J Manag Care Date: 2015-09 Impact factor: 2.229
Authors: Katherine A Yeager; Whitney E Zahnd; Jan M Eberth; Robin C Vanderpool; Catherine Rohweder; Randall Teal; Maihan Vu; Lindsay Stradtman; Elizabeth L Frost; Erika Trapl; Sarah Koopman Gonzalez; Thuy Vu; Linda K Ko; Allison Cole; Paige E Farris; Jackilen Shannon; Natoshia Askelson; Laura Seegmiller; Arica White; Jean Edward; Melinda Davis; Victoria Petermann; Stephanie B Wheeler Journal: J Cancer Surviv Date: 2022-01-26 Impact factor: 4.062