Burden on Treatment Costs Impact Quality of Life Among Melanoma Survivors

Financial toxicity and excessive financial burden appeared common among melanoma survivors, frequently leading to disease-related distress, according to research presented at the 2017 ASCO Annual Meeting.

Few survivors reported engaging in financial discussions with their oncology care providers prior to treatment initiation. 

“Melanoma survivors are at risk for significant financial burden due to cancer care and out of pocket costs,” Joanne S Buzaglo, PhD, senior vice president of research and training at Cancer Support Community, and colleagues wrote. “We explored  the financial impact of melanoma and its relationship to cancer-related distress, and survivors’ experiences discussing financial burden with their health care team.”

Dr Buzaglo and colleagues distributed surveys concerning treatment-related financial burden, distress, and financial conversations with medical professionals to 110 melanoma survivors enrolled in Cancer Support Community’s Cancer Experience Registry. Survivors were asked to rate their level of concern in 27 separate areas on a scale from 0 (not at all concerned) to 4 (very seriously concerned).

Fifty-six survivors returned completed surveys (median age, 54 years; 71% women; median time from diagnosis, 2.5 years). Thirty-four percent reported an annual income below $60,000, and 24% said their monthly out-of-pocket treatment costs exceeded $500.

Sixty-nine percent of respondents reported being moderately to very concerned about health insurance and financial matters. Fifty-seven percent reported draining their savings to pay for medical costs, while 20% borrowed against retirement money. Survivors commonly reported skipping medicine doses (13%) or delaying prescription refills (17%) to save money.

Among individuals with an annual income below $60,000, financial burden was associated with increased distress (P < .05).

Twenty-eight percent of survivors reported an initial conversation related to costs of care with their medical providers; additionally, 28% reported conversations concerning financial distress. The researchers also found that 42%  of survivors have sought financial assistance to pay for medical care.

“These results support the development and evaluation of interventions to enhance doctor-patient communication, and financial counseling to minimize burden of melanoma and the risks it can confer for quality of life, course of cancer care, and health outcomes,” Dr Buzaglo said.—Cameron Kelsall