Calling Dr. Advisor: Financial Planning Helps Treat Cancer

Might a financial professional be part of the team treating cancer patients? That would make sense considering the positive outcomes when patients are treated for “financial toxicity.”

In the United States, even patients with health insurance struggle with expenses associated with cancer care. Studies have identified that financial toxicity degrades quality of life and even health outcomes, and a recent one has demonstrated that intervention can make a difference.

When leukemia and blood disease patients were assisted with costs related to medical expenses and daily living, they had a significant improvement on health outcomes, according to a study conducted at the Malignant Hematology Clinic at the Levine Cancer Institute in Charlotte, N.C., and presented at a conference.

The Foundation for Financial Planning, which sponsored the research, said that financial difficulty had a high correlation with mortality – cancer patients going into bankruptcy are 80% more likely to die than other cancer patients.

“Financial toxicity (FT) has been consistently demonstrated to a be a major contributor to morbidity and mortality in a variety of cancers,” according to the intervention study. “This pilot study attempts to identify patients at high-risk due to FT in a busy clinical environment and improve clinical outcomes with comprehensive intervention.”

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The study’s lead investigator, Dr. Thomas G. Knight, had led a previous study that identified how malignant financial toxicity can be.

“More than 25% of adults with cancer reported financial toxicity that was associated with an increased risk for medical noncompliance,” that study reported. “Financial toxicity remains a major issue in cancer care, and efforts are needed to ensure patients experiencing high levels of financial toxicity are able to access recommended care.”

The latest study identified financially struggling patients and intervened to see if financial assistance would improve outcomes. The patients’ level of financial toxicity was identified by a questionnaire gauging patients’ anxiety around their ability to pay for care and other expenses.

Those patients were found to comply less with the treatment regimen by skipping medications and doctor visits.

“Patients in the intervention cohort had high rates of noncompliance due to inability to afford prescription medications (16.8%), OTC medications (15.9%), and doctor visits (6.5%),” according to the study. “In order to pay for their care, patients reported reducing spending on food and clothing (48.6%), using savings to cover OOP expenses (51.4%), and partially filling prescriptions (11.2%).”

Besides the direct medical effect, these patients were found to be more likely to deplete their savings and raid their retirement accounts. Some have had to choose between food and care, with more than a third cutting back on their groceries.

Patients experiencing financial toxicity were entered into a three-step intervention program.
They first met with a nurse navigator who helped identify opportunities for grant funding and other financial assistance. Next, they worked with a clinical pharmacist for help with assistance programs. Then they had a community pro-bono financial planner help them with budgeting, asset management and financial advice.

Patients were provided with other assistance such as gas cards and coordinated help with food pantries and transportation.

The researchers wanted to see if intervention could work in a busy clinic environment. They used a brief questionnaire to determine need, leading to a rapid acceptance into the program. The study concluded that it can work and shows a positive impact.

“The intervention resulted in statistically significantly higher quality of life when measured by PROMIS physical and mental health scores, compared to baseline scores,” the researchers wrote, referring to common health metrics.

The Foundation for Financial Planning provides pro bono financial planning for people in need. The intervention study found that more than 50% of patients wanted to work with a financial professional.

Steven A. Morelli is a contributing editor for InsuranceNewsNet. He has more than 25 years of experience as a reporter and editor for newspapers and magazines. He was also vice president of communications for an insurance agents’ association. Steve can be reached at stevenamorelli@gmail.com.

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