Many cancer patients juggle care along with financial pain

Associated Press

Josephine Rizo survived chemotherapy, surgery and radiation, but breast-cancer treatment wrecked her finances.

Money already was tight when doctors told the Phoenix resident she had an aggressive form of the disease. Then she took a pay cut after going on disability leave, and eventually lost her job and insurance coverage. During treatment, Rizo got swamped with more than $50,000 in medical bills.

“My concern was, ‘Am I going to die?’” she said. “I had to kind of focus 100 percent on my health to make sure I was around for my kids.”

As treatment costs soar and insurance coverage shrinks, hospitals and patient advocates around the U.S. are rushing to offer more help to patients such as Rizo, who had no financial counseling. Cancer centers are hiring experts to help patients navigate the insurance system, while nonprofits are teaching people to think about handling costs when treatments starts instead of waiting for a financial crisis to hit.

“We know a lot of very solidly middle class families, they were fine and then ... their financial lives changed,” said Jean Sachs, CEO of the nonprofit Living Beyond Breast Cancer. “They’re not prepared for the cost of cancer, let alone the care.”

Cancer has long been an expensive disease to treat, but several factors have made the financial sting more intense in recent years, prompting more patients to delay treatment or cut back on their medications.

Insurers are tightening their prescription drug coverage and raising patient costs such as deductibles as treatment prices soar. That means patients may have to pay several thousand dollars a year for a drug like the leukemia treatment Gleevec – a pill taken daily, sometimes for the rest of a person’s life.

The Affordable Care Act sets limits for how much people have to spend on care each year. But cancer treatments often extend beyond a year, and those limits don’t apply to care sought outside the increasingly narrow network of doctors and hospitals that some insurers offer.

Patient costs also can rise because newer cancer treatments are more tolerable, so people can stay on them longer, said Dr. Yousuf Zafar, a Duke Cancer Institute oncologist who studies financial distress.

A few years ago, Zafar and colleagues surveyed 300 adult, insured patients at the cancer institute. Nearly 40 percent reported a higher-than-expected financial burden, while 16 percent dealt with what he called “overwhelming financial distress.”

More than a quarter of that patient population said they didn’t take their medicines as prescribed. That meant skipping doses, taking smaller amounts or not filling prescriptions because of the cost.

Other research has found that cancer patients are more than twice as likely as those without the disease to declare bankruptcy.

More than 1.7 million new cancer cases will be diagnosed this year, according to the American Cancer Society. Who winds up in financial trouble will depend on factors like the patient’s income, savings and insurance coverage.