Cancer Costs: A Financial Freefall

⏱️ 11 min read       

Cancer is capsizing Americans' finances. It’s bad enough to be diagnose with cancer, but to then be slapped with the immense cost of medication required to help you stay alive is another. Imagine battling a life-threatening illness while watching your finances crumble into dust. It’s the patient, the family, the children who have to deal with the devastating impact of skyrocketing drug prices, overwhelming out-of-pocket costs, and the loss of income that leaves many patients in financial ruin. 

Welcome to That's Life, I Swear. This podcast is about life's happenings in this world that conjure up such words as intriguing, frightening, life-changing, inspiring, and more. I'm Rick Barron your host. 

That said, here's the rest of this story

So, there you are. The benchmark picture of financial stability, gainfully employed, insured, and comfortably settled in your own home. But then, your world caves in and you’re about to take the most emotional roller coaster ride of your life. During your yearly checkup, you discover you have cervical cancer. A diagnosis shatters you beyond what you could imagine, but only to find out you’ll soon be drowning in tens of thousands of dollars of medical debt. 

The grueling rounds of chemotherapy can sap your energy, and other health complications, including a stroke, compounding your struggles. The physical toll is so severe that you lose your job. An eviction notice appears at your doorstep because you’re behind in your mortgage, and your car gets repossessed.

Again, one morning, your life is picture perfect, and in the blink of an eye, you lose everything. Think this couldn’t happen to you?

The financial toll of battling cancer in the United States is reaching staggering heights as the expenses for treatments and medications continue their relentless climb upwards. A shocking proportion, over half, of the new cancer drugs brought to market between 2019 and 2023 demand an annual price tag exceeding $200,000 according to data from Iqvia's Institute for Human Data Science. Compounding this burden is the disturbing reality that an escalating number of those afflicted are individuals of working age - a demographic more subject to confronting severe financial hardships following a cancer diagnosis when compared to their older counterparts.

The data paints a grim picture: nearly three-fifths of working-age cancer survivors face varying degrees of financial distress. Many struggle to afford the necessary care, forcing them to incur substantial debt. Others turn to desperate measures like payday loans or maxing out their credit cards in a futile attempt to keep their heads above water. Research indicates that 40% of crowdfunding campaigns on platforms like GoFundMe seeking financial assistance are directly tied to individuals battling cancer.

For many who cannot meet the high cost of medical care, particularly with cancer treatment, contemplate their options:

·       Skipping medication doses 

·       Foregoing doctor appointments

·       Compromising food intake

These options and others are unacceptable consequences that no individual battling cancer in our nation should have to endure.

Among prevalent diseases, cancer exerts a uniquely devastating financial strain, a phenomenon termed "financial toxicity." Treatment regimens involving high priced medications commence immediately, accompanied by an array of non-medical expenses. Chemotherapy and other therapeutic procedures can render patients too debilitated to maintain employment for weeks or months, delivering a dual blow: loss of income coupled with the potential loss of 
employer-sponsored health insurance. The financial repercussions can reverberate for many years.

It can precipitate a cataclysmic depletion of wealth, the ripples of which persist indefinitely. Debt collectors continue to hound you regarding unpaid medical bills.

The root of the problem stems from the soaring costs of medical care and cancer drugs, which have escalated far beyond the rate of inflation or have sky rocketed to high starting prices from the outset. Commonplace cancer medications bear price tags that defy comprehension, often exceeding hundreds of thousands of dollars: 

·       Imbruvica, a treatment for leukemia, carries a staggering list price surpassing $213,000 for a full year's supply. Federal data reveals that the average Medicare patient taking this drug shouldered an out-of-pocket expense of $5,247 in 2022 alone. 

·       Tagrisso, a top-selling lung cancer drug, demands an annual list price of approximately $208,000 – and that's per year, mind you.

Many insurers have shifted the mounting healthcare costs onto the shoulders of patients themselves. Certain employer-backed plans mandate that individuals pay a percentage of a drug's cost, an amount that can rapidly accumulate into the thousands of dollars. One report uncovered a 15% increase in out-of-pocket expenses for privately insured, working-age cancer patients between 2009 and 2016. 

The added financial strain is merely one facet of the toll exacted, as individuals' livelihoods are also jeopardized. Numerous patients are compelled to take extended leave or altogether cease working following a cancer diagnosis. Those undergoing chemotherapy are more likely to discontinue employment within four years compared to those who do not receive such treatment.

The burden frequently extends to entire families, with relatives contributing financially or assuming caregiving responsibilities for their ailing loved ones. 

Individuals afflicted with cancer face a significantly elevated risk of falling behind on credit card payments, mortgage obligations, and encountering other financial challenges compared to those without cancer. There have been cases where people liquidate the majority of their 401(k) to stay afloat financially.

Additional studies demonstrate that patients burdened with higher out-of-pocket expenses are more likely to delay initiating their prescribed medications or discontinue taking them altogether. Theres’s a striking correlation: cancer patients who file for bankruptcy exhibit an 80% higher risk of mortality compared to those who do not resort to bankruptcy proceedings.

The detrimental impact on survival rates is quite substantial.

The mounting hardship has galvanized advocates and doctors to seek patchwork solutions, but gaping holes remain in the safety net.

An increasing number of cancer centers now offer financial assistance programs for patients struggling with economic challenges, and nonprofits help defray costs associated with food, travel, and other essential needs. However, their funding is finite, and many individuals remain unaware of how to access these resources. Only a small fraction of patients who turn to crowdfunding platforms like GoFundMe to solicit financial aid achieves their fundraising goals.

The American Cancer Society conducted a survey on how best help reduce 
cancer-related medical debt and help families already burdened by medical debt:

·       62%: ensuring patients receive the full benefit of drug discount and assistance programs

·       61%: ensuring more patients have access to provider assistance programs

·       59%: increasing access to patient navigators

·       52%: patients who need it are directed to financial assistance before they begin care

·       45%: ensuring patients don’t receive surprise medical bills would be most helpful.

Best ways to help those with medical debt

·       54%: agree that prohibiting predatory and discriminatory debt collection practices would be of greatest help 

·       51%: removing medical debt as a factor in evaluating an individual’s creditworthiness 

·       47%: Limit interest rates charged on medical debt

·       46%: Minimizing sales of medical debt to medical debt collectors

Addressing medical debt in the U.S. is crucial to accomplishing ending cancer as we know it for everyone. In order to effectively achieve that reality, all individuals must first and foremost have access to quality and affordable health insurance coverage. 

We need to look at supported public policies that make insurance options with affordable premiums, comprehensive benefits and affordable cost-sharing available to all individuals.

To make health care affordable, we have to prevent people with cancer, survivors, caregivers and their families from incurring debt as a result of necessary cancer treatment. 

Where medical debt cannot be prevented, at the very least, aim to minimize the negative impacts medical debt has on a patient’s health, quality of life, and financial wellbeing.

What can we learn from this story? What's the takeaway?

Cancer patients frequently must choose between paying for treatments and paying for rent, utilities, food or other necessities. In many cases, patients use their life’s savings to pay for their treatments. Sometimes, they must go even declare bankruptcy.

I thought this was America. You know the motto: The United States of America, the most powerful country in the world?

Well, there you go, my friends; that's life, I swear

For further information regarding the material covered in this episode, I invite you to visit my website, which you can find on Apple Podcasts, for show notes calling out key pieces of content mentioned and the episode transcript.

As always, I thank you for the privilege of you listening and your interest. 

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