Cancer patients want to talk with doctors about costs

Researchers at Duke Cancer Institute have found that most cancer patients would like to talk about the cost of care with their doctors, but they often don't because they fear the discussion could compromise the quality of their treatment.

But patients who do bring up the subject of finances believe it helps decrease their costs. 

Researchers surveyed about 300 insured patients treated at Duke and affiliated clinics in rural North Carolina. 

Dr. Yousuf Zafar, assistant professor at Duke and lead author of the study, said 57 percent of participants in the survey said they wanted to talk about treatment costs with their doctors, but only 19 percent actually had that conversation.

“There’s a real disconnect,” Zafar said. “Even people with the highest needs aren’t bringing up costs as part of the decision-making process.”

Some respondents said they were embarrassed to bring up cost. Others didn’t think it was something their doctor could help with or should worry about. Twenty-eight percent said they wanted the best possible care regardless of cost. 

“We found that when patients did talk about costs with their doctors, many felt they gained something from the discussion – that their expenses were reduced,” Zafar said. 

Zafar said this suggests the "perceived barriers to the cost conversation aren't real" and that doctors should have tools to identify patients who need financial help and direct them to appropriate resources.

“With today’s evolving health insurance landscape, cancer treatment-related costs to patients are more important than ever,” Zafar said. “...Knowing that patients want to have these discussions should give us confidence in making this a routine practice.” 

The research will be presented June 3 at the 2013 Annual Meeting of the American Society of Clinical Oncology in Chicago. 

The study was funded by the Duke Cancer Institute Cancer Control Pilot Studies Award, the Duke Clinical Research Institute Comparative Effectiveness Research KM1 Award, and an American Cancer Society Mentored Research Scholar Grant.