Cancer patients tell of financial stress

It's bad enough to have cancer. Paying for it pushes some patients toward financial ruin, adding a layer of stress that the medical system is not addressing adequately, a Philadelphia-based organization for social workers says.

The Association of Oncology Social Work released results today of a survey of cancer patients and caregivers that found significant financial problems even among patients who had insurance. The survey sample was small - 169 patients and 131 caregivers. Ninety-five percent of patients had insurance.

Many types of cancer were represented, but a third of the patients had multiple myeloma. The survey was sponsored by Millennium Pharmaceuticals Inc., a company that makes a drug for multiple myeloma that costs $1,290 a dose, wholesale. Millennium did not design the survey.

Nearly 40 percent of the patients said the cost of their cancer treatment was causing a serious financial burden. Eleven percent characterized their financial problems as "catastrophic." Forty percent said they had "depleted" their savings, and more than a quarter had asked family or friends for money.

Patients said their out-of-pocket costs were about $700 a month, with prescription drugs the biggest expense. When asked how they reduced medical costs, 29 percent said they had either not filled a prescription or delayed doing so; 23 percent had skipped a doctor's appointment; 22 percent had skipped a dose of medicine; and 19 percent had cut a dose in half.

Mary Ann Burg, a Florida social worker who is research director for the association, said patients' financial problems were worsening as more became underinsured or uninsured.

Not surprisingly, Burg said she thought the health system needed more social workers, who are trained to help with psychosocial problems. Many hospitals have cut social work staffs in recent years. Large academic hospitals are more likely than community hospitals to have oncology social workers, she said.

"People need help. They need support when they're going through these problems after a cancer diagnosis," Burg said. "It's important to get the message out that things are getting worse for cancer patients, as they are for most people dealing with health-care crises, and we need a lot more support for people going through these times in their lives."