Treatment out-of-pocket cost communication and remote financial navigation in patients with cancer: a feasibility study

• Published in: Supportive care in cancer Vol. 30; no. 10; pp. 8173 - 8182
• Main Authors: Sadigh, Gelareh, Coleman, Debrua, Switchenko, Jeffrey M., Hopkins, Judith O., Carlos, Ruth C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2022; Springer; Springer Nature B.V
• Subjects: Adult; Cancer; Cancer patients; Communication; Economic aspects; Feasibility Studies; Female; Financial management; Health care expenditures; Health Expenditures; Humans; Male; Medicine; Medicine & Public Health; Neoplasms - therapy; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Patients; Pilot Projects; Poverty; Rehabilitation Medicine; Surveys; Out-of-pocket communication; Financial hardship; Financial navigation; Cancer
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-022-07270-5

Objective We conducted a pilot study assessing the feasibility of a personalized out-of-pocket cost communication, remote financial navigation, and counseling (CostCOM) intervention in cancer patients. Methods Twenty-three adult, newly diagnosed cancer patients at a single community oncology practice were asked to complete a survey and participate in a CostCOM intervention, including patient - specific out-of-pocket cost communication, remote financial navigation, and counseling. Feasibility was defined as patient participation in CostCOM, and its impact on financial worry measured using the Comprehensive Score for Financial Toxicity (COST) (higher score = less worry) was assessed. Eight patients’ and two providers’ experience with CostCOM was evaluated using qualitative interviews. Results Mean patient age was 61 (78.3% female; 100% white). Of 23 CostCOM patients, 86.9% completed CostCOM, 60% of them completed a financial assistance application, and 25% of those who applied were enrolled in a co-pay assistance program. Patients’ financial worry significantly improved following CostCOM (COST score of 10.0 ± 9.6 at enrollment vs. 16.9 ± 8.1 at follow-up; p  < 0.001). Mean general satisfaction (out of 5) with CostCOM was 4.1 ± 0.7. In qualitative interviews following OOPC communication, 75% felt a positive impact on their mental health, and all patients reported no change in their treatment plan; 83.3% found financial navigation beneficial. In providers’ interviews, buy-in from relevant stakeholders, integration of the CostCOM with existing workflow, and larger studies to assess the effectiveness of CostCOM were identified as factors needed for CostCOM implementation in practice. Conclusion CostCOM interventions are feasible and acceptable and decrease financial worry in patients with cancer.