Finances impact cancer survivors’ use of medications

Many cancer survivors can’t afford to take all their medications the way they were prescribed, which can lead them to make changes that include skipping doses or delaying filling prescriptions. This problem appears to mainly affect adults younger than age 65, according to a recent study by researchers from the American Cancer Society, the Centers for Disease Control and Prevention, and the National Institutes of Health. Researchers used data from the National Health Interview Survey to learn how finances led people to change their prescription drug use. The survey included about 135,000 people, including almost 9,000 cancer survivors.

Among cancer survivors ages 18-64, about 32 percent of those diagnosed within the past two years and about 28 percent of those diagnosed at least two years ago reported changing their prescription drug use because of financial reasons. This compared with only about 21 percent of those with no history of cancer.

“Specifically, non-elderly cancer survivors were more likely to skip medication, delay filling a prescription, ask their doctor for lower-cost medication, and use alternative therapies for financial reasons compared with non-elderly individuals without a cancer history,” said the American Cancer Society’s Ahmedin Jemal, DVM, Ph.D., a senior author of the paper.

Meg Beshey, cancer survivor, mother of two daughters and a Fort Dodge resident, has experienced firsthand the stresses and many challenges of paying for expensive medications that are necessary for treating her disease. She worries every day about the financial burden associated with her diagnosis and has been forced to make significant changes in her life due to her ongoing high medical expenses.

“I’ve been forced to cut back on my own medications, multiple times, due to my lack of financial resources to cover these high costs,” Beshey said. “It’s important that our healthcare providers not only talk about the physical and emotional side effects of having cancer, but also help us prepare, organize and deal with the negative financial side effects that come with treating cancer. These kinds of conversations are very important and need to be happening more often. The cost and high expenses that come with cancer is a burden not only for me, but for my entire family.”

For those ages 65 and older, changes in prescription drug use for financial reasons were generally similar between cancer survivors and those with no cancer history. The differences between age groups are likely due to several factors:

• Younger people are more likely to have financial commitments including mortgages, college tuition, and dependent family members.

• Younger people are more likely to still be working and relying on a paycheck; however, a cancer diagnosis can lead to missed work days and other barriers to working that can reduce income.

• If barriers to working lead to job loss, employment-based insurance coverage can be lost, too, increasing the chances of delaying or missing care.

• Uniform health care coverage through Medicare means people age 65 and older are more likely to have and keep affordable health insurance.

According to a new study by researchers from Virginia Commonwealth University, almost one-third of cancer survivors experience financial hardships because of their diagnosis and/or treatment. These hardships can have long-lasting physical and mental side effects.

The background information in the study, estimated out-of-pocket expenses for people with cancer average from $1,730 to $4,727 per year depending on insurance coverage. Survivors who have trouble paying these costs are more likely to skip or delay medical care including mental-health care, and avoid filling prescriptions. This can put their physical and mental health at risk and increase their risk of cancer coming back.

Researchers looked at the records of 19.6 million cancer survivors from the 2011 Medical Expenditure Panel Survey, which collects information about how Americans use and pay for health services. Researchers classified survivors as having a financial problem if they reported borrowing money, declaring bankruptcy, worrying about paying medical bills, being unable to pay for medical visits, or making financial sacrifices.

They found that 28.7 percent of survivors reported at least one financial problem resulting from cancer diagnosis, treatment, or long-term side effects of treatment. Of all 19.6 million survivors: 20.9 percent worried about paying large medical bills, 11.5 percent were unable to pay for medical visits, 7.6 percent borrowed money, went into debt or declared bankruptcy and 8.6 percent said they made other financial sacrifices.

Compared with cancer survivors who did not face financial problems, those who did had lower physical and mental health-related quality of life, higher risk for depressed mood and psychological distress, and were more likely to worry about cancer coming back. The more financial problems survivors faced, the more their mental health-related quality of life decreased. Cancer survivors who had to borrow money or declare bankruptcy had the worst physical and mental health-related quality of life. The researchers estimate that approximately 1.5 million cancer survivors in the U.S. are in in this situation.

The researchers recommend that doctors:

• Look for treatments that are less expensive while still being just as effective.

• Discuss treatment costs with patients.

• Involve patients in making decisions about treatment.

For their part, survivors and their families can educate themselves about their health care coverage and research organizations that provide financial assistance.

The American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), are committed to addressing the unequal burden of cancer, including access to treatment and affordable cancer treatment. ACS is a global grassroots force of 2 million volunteers saving lives in every community. We’re finding cures as the nation’s largest private, not-for-profit investor in cancer research, ensuring people facing cancer have the help they need and continuing the fight for access to quality health care, lifesaving screenings and cancer prevention. For more information, to get help, or to join the fight, call us anytime, day or night, at (800) 227-2345 or visit cancer.org.

Join the movement to fight cancer at the American Cancer Society Relay For Life of Webster County on Saturday, June 17 at the City Square from 11 a.m. to 3 p.m.

Liddy Hora is Health Systems Manager, American Cancer Society. She can be contacted at liddy.hora@ cancer.org.

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