After Surviving Cancer, Bankruptcy Looms Large in Working-Age Individuals, Says Kaiser Study

A new study conducted by researchers at Kaiser Permanente has found that a considerable number of working-age adults who survive cancer and its toxic treatments, end up with substantial medical debts or declare bankruptcy.

The collaborative study, which also included researchers at the National Cancer Institute, CDC, Emory University, and the LIVESTRONG Foundation, analyzed data on 4719 cancer survivors between the ages of 18 and 64 years. The data was part of the LIVESTRONG 2012 survey, which was developed by the LIVESTRONG Foundation to improve the understanding on some of the practical issues and concerns of cancer survivors. In addition to their experience with finances and insurance coverage, survivors answered questions about survivorship care plans and fertility.

For the present study published in the current issue of the journal Health Affairs, the authors analyzed data on about 75% of the parent cohort and found that one-third of these survivors had gone into debt and 3% had filed for bankruptcy following their cancer treatment. More than half of those in debt owed at least $10,000. Additionally, the study found that younger survivors (who were probably yet to establish a career and earn a steady income), those with lower incomes, and those with public health insurance were at a greater risk of going into debt or filing for bankruptcy, compared with older, high income bracket, or privately insured survivors, respectively.

Based on their 2012 survey, LIVESTRONG released a brief documenting the following statistics:

• 30% of survivors reported that they or their family members had to borrow money or go into debt because of their cancer, its treatment, and lasting effects.
• 71% of survivors reported that they had to pay out of pocket for medications and/or medical equipment and supplies.
• 10% of survivors who applied for insurance were denied because of their diagnosis. Out of those who were insured, 17% were refused coverage for doctors’ visits with a provider or facility of their choice.

In an interview with The American Journal of Managed Care, Yousuf Zafar, MD, MHS, a health policy researcher at Duke Cancer Institute who has been credited for coining the term “financial toxicity,” explained that physicians can play an important role in this process. “One simple question could save some patients a lot of money. Just asking patients ‘Do you have prescription drug coverage?’ that’s a first, very simple step to integrating costs into the medical treatment decision making.”

The lead author of the study, Matthew Banegas, PhD, MPH, at Kaiser Permanente Center for Health Research, told NBC News that cancer patients can also lose time at work. If they have to take time off, they may have to use extended time or extended leave which could impact insurance coverage and impact how cost affects them.” Indeed a study recently published in JAMA found that cancer patients who cannot avail of paid sick leave face significant financial strains.