Addressing Financial Toxicity and Clinical Trial Disparities in Community Oncology

At an Institute for Value-Based Medicine event in November 2024, experts discussed how social determinants of health worsen cancer care disparities in Houston, Texas. In this interview from the event, Susan Escudier, MD, FACP, medical oncologist and vice president of value-based care and quality programs at Texas Oncology, explained how community oncology practices can address these challenges by leveraging financial assistance programs and expanding clinical trial access to rural areas.

This transcript was lightly edited and captions were auto generated.

Transcript

How can community oncology practices better address the impact of financial toxicity on cancer care disparities?

I think one of the ways is by taking advantage of all the discounts that are available. For example, when we prescribe medications, many of our patients get foundation assistance, and we have a team in our pharmacy that coordinates things like rebate cards [and] foundation support. The problem, of course, is that it is very irregular; companies vary tremendously.

We also have social workers that sometimes can help if patients need government assistance programs. Some communities, you can get things donated to patients to help their extra expenses, things like transportation or places to stay, but it's a tough problem because it's a very fragmented safety net.

What strategies have helped improve clinical trial enrollment among underserved populations?

In Texas Oncology, one of the ways we've been able to increase the diversity of our trials is just by having them available in almost all of our clinics. That way, if you're in a rural area, you still have access to research studies that you might think of as being restricted to big urban hospitals or cancer centers.

I also think that there's a lot of interesting information out there about finding patients where they are [and] engaging patients in communities—so, if you're going to be doing research in a community, actually talking to the people in that community to see what works for them. Probably what's successful in a predominantly Spanish-speaking population in the Rio Grande Valley might be different than what's successful in West Texas, and that's where we rely on the local knowledge of our physicians and clinic staff.