About Half with Cancer Want to Discuss Care Costs with Physician, But Fewer Do, Study Finds

Rising costs in cancer care, especially for new therapies, have gained attention in recent years. However, a study just published in The American Journal of Managed Care finds about half of patients are interested in discussing cost on the front end, but only a minority actually have a cost discussion with their oncologist.


PLAINSBORO, N.J.— About half the cancer patients in a new study were interested in discussing the cost of their care with their doctor, and about half wanted the doctor to take cost into account when planning their treatment, according to a study just published in The American Journal of Managed Care.

“The Utility of Cost Discussions Between Patients With Cancer and Oncologists,” led by S. Yousuf Zafar, MD, MHS, of Duke Cancer Institute, stems from a survey of 300 patients between November 2012 and June 2013. While 52% said they wanted to talk to their doctors about the cost of care, and 51% wanted financial considerations factored into their treatment, only 19% actually had a cost discussion. Patients were more likely to seek these conversations if they were in financial distress, and the willingness to discuss cost increased over the course of treatment, as bills began to mount. For the full study, click here.

African-American patients, however, were less interested in discussing the cost of cancer care; the authors write that research has long suggested that African-American patients are less likely to be actively involved in medical decisions with their physicians, and “subsequently, have lower trust in their physicians.”

The study found that patients who did not talk to their doctor about cost of care often said they could afford to pay (53%). Over one third reported that they wanted the best possible care no matter what it cost (34%), suggesting some patients fear they might receive lesser quality care if they have a cost discussion. Some felt it wasn’t their doctors’ job to worry about their medical bills (23%) or that they were embarrassed (5%).

But when patients did talk to their doctors, it brought results. “We found that more than half of patients who discussed finances with their doctor reported lower out-of-pocket costs as a result of that discussion,” the authors wrote. “Most of the time, costs were reduced without actually changing the care that was delivered.”

Dr. Zafar will take part in the upcoming conference being presented by The American Journal of Managed Care: Patient-Centered Oncology Care, an annual gathering in Baltimore, Maryland, brings together stakeholders from across the healthcare spectrum. He will join an elite group of experts, including Julie M. Vose, MD, MBA, FASCO, the president of the American Society of Clinical Oncology, on November 15-16, 2015. For registration, please visit http://www.ajmc.com/meetings/pcoc15.

About the Journals and AJMC.com

The American Journal of Managed Care celebrates its 20th year in 2015 as the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Pharmacy Benefits, which provides pharmacy and formulary decision-makers with information to improve the efficiency and health outcomes in managing pharmaceutical care, and The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policy makers, and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.


Nicole Beagin

(609) 716-7777 x 131