{"entity":{"id":"idea-cost-financial-toxicity-screening","kind":"idea","name":"Screen every patient for money trouble the way we screen for pain","aka":[],"tldr":"People with cancer are far more likely to go bankrupt than people without, and the ones who do have worse survival; a two-question screen at diagnosis plus a financial navigator catches the problem while it can still be fixed.","summary":"A Washington State study linking cancer registry and court records (Ramsey et al., Health Affairs 2013) found people with cancer were 2.65 times more likely to file for bankruptcy than matched controls. Validated tools (COST, a financial-toxicity score) take two minutes. Financial navigators enrol patients in manufacturer, charity and public programmes, appeal denials and set up payment plans. Making screening a quality measure and navigation a reimbursable service would spread it beyond the large centres that already have it.","asOf":"2026-09-10","links":[{"label":"Ramsey et al., Health Affairs 2013: Washington State cancer patients and bankruptcy","url":"https://doi.org/10.1377/hlthaff.2012.1263"},{"label":"OnCo financial help browser","url":"https://onco-umber.vercel.app/assistance/"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["financial-toxicity"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-care-fragmentation","b-patient-voice"],"keyPapers":["paper-ramsey-health-aff-millwood"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Universal financial-toxicity screening with navigation will reduce the share of patients reporting severe financial distress at six months by a third and reduce treatment non-adherence for cost reasons.","rationale":"Every large centre that has published its navigation programme reports millions of dollars of assistance secured per navigator per year; the evidence gap is in smaller and rural practices.","test":"A cluster-randomised trial of screening plus navigation in community practices with distress scores, adherence, assistance secured and bad debt as endpoints.","maturity":"being-tested-at-scale","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-cost-financial-toxicity-screening/","neighbours":{"term":[{"id":"financial-toxicity","kind":"term","name":"Financial toxicity","route":"/terms/financial-toxicity/"}],"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-ramsey-health-aff-millwood","kind":"paper","name":"Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis","route":"/key-papers/paper-ramsey-health-aff-millwood/"}],"technology":[{"id":"rejuv-life-employment-rights-us","kind":"technology","name":"Employment rights with cancer in the United States","route":"/technologies/rejuv-life-employment-rights-us/"},{"id":"rejuv-life-money-after-treatment","kind":"technology","name":"Money after treatment: what the cost of cancer does once the treatment has finished","route":"/technologies/rejuv-life-money-after-treatment/"}]}}