Financial Toxicity and Cancer Treatment (PDQ®)–Health Professional Version

Changes to This Summary (12/13/2018)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Financial Toxicity Associated With Cancer Care—Background and Prevalence

Revised text to state that commercial insurers in the United States are shifting more direct medical care costs to patients through higher premiums, deductibles, and coinsurance and copayment rates. The 2016 Commonwealth Fund Biennial Health Insurance Survey indicated that 33% of insured adults aged 19 to 64 years had medical bill problems or accrued medical debt (cited 2016 Biennial Health Insurance Survey, Commonwealth Fund as reference 12).

Revised text to state that the proportion of health care plans with multitiered prescription formularies, in which expensive oral specialty drugs are associated with the highest cost sharing, increased from 3% in 2004 to nearly 88% in 2017 (cited Employer Health Benefits Survey, Henry J. Kaiser Family Foundation as reference 13).

Consequences of Financial Toxicity Among Cancer Patients

The Access and Adherence to Treatments subsection was renamed from Adherence to Treatments.

Added text to state that a study using data from the 2011 to 2014 National Health Interviewsurvey found that nonelderly individuals with a recent or previous cancer diagnosis were more likely to report changing their prescription drug use for financial reasons than those individuals without a history of cancer (cited Zheng et al. as reference 3). Also revised text about another study that examined the association between imatinib copayment and medication adherence among patients with chronic myeloid leukemia, from 2002 to 2011, using MarketScan health plan claims.

Added text to state that anecdotal reports also suggest that terminally ill cancer patients are foregoing the opportunity to obtain lethal doses of barbiturates in states with death-with-dignity laws because the price of these generic medications has increased to approximately $3,000 for a typical prescription (cited Shankaran et al. as reference 6).

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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