FCS’ Gordan Leads Study That Shows Community Oncology Practices Limit Financial Toxicity

Independent community oncology practices significantly reduce the levels of financial toxicity that patients with cancer experience, compared with that seen by patients treated in hospital outpatient settings, according to a new study appearing in the American Journal of Public Health.¹

The study was led by Lucio Gordan, MD, president and managing physician of Florida Cancer Specialists and Research Institute (FCS). Several coauthors are in leadership at FCS.

Financial toxicity is term that first appeared in the literature around 2013, with the rise of immunotherapy. It is defined as the economic burden of cancer care to patients and their families, to the point that it affects their wellbeing.

The study, “The Role of Utilizing Community Oncology Care To Decrease Cancer-Related Financial Toxicity,”¹ analyzes real-world claims data and identifies dramatic cost differences driven by lower drug markups, reduced facility fees, and more efficient care delivery in independent community settings.

The research team found that patients treated in community oncology clinics had a mean monthly cost of care that was 24% lower than the hospital outpatient setting: 12,548 in the community setting compared with $16,555 in hospital outpatient settings.

The study isolated a comparison of branded chemotherapy. Costs in community oncology were 39% less on average, at $6674 in the community oncology setting vs $10,900 in hospital-based clinics.¹

“These findings reinforce what many of us in community oncology have long observed,” Gordan said in a statement released by the Community Oncology Alliance (COA), which represents independent community practices. “Patients benefit not only from compassionate, personalized care close to home, but also from dramatically lower financial strain during one of the most difficult periods of their lives.”²

The study highlights the impact that drug markups and facility fees have on patients’ total cost of care; both are substantially higher in hospital-based oncology departments. Due to the design of many health plans, including Medicare, drug markups have a direct impact on patient out-of-pocket costs. Even the popular $2000 out-of-pocket cap only applies to Medicare Part D, not infused drugs covered by patients’ medical benefits.

“This new data reaffirms what COA has championed for years—that community oncology is the backbone of cancer care in this country, delivering better value and outcomes for patients,” said Ted Okon, executive director of COA. “As policymakers and stakeholders evaluate solutions to rising cancer costs, it is critical that we do everything we can to support and strengthen the independent community oncology system.”

References

1. Gordan LS, Singh-Bulkan N, Warner A, et al. The role of utilizing community oncology care to decrease cancer-related financial toxicity. Am J Public Health. ISSN 3064-6677.
2. New study shows community oncology plays critical role in reducing cancer related financial toxicity for patients. News release. Community Oncology Alliance. December 1, 2025. Accessed December 3, 2025. https://bit.ly/4rB2LZD