{"entity":{"id":"idea-reg-financial-toxicity-vital-sign","kind":"idea","name":"Screen every cancer patient for financial toxicity as a vital sign, with navigation","aka":[],"tldr":"Cancer costs push patients into debt and make them skip treatment. Asking about money at every visit, and having someone to help, catches this before it does harm.","summary":"Financial toxicity affects a large share of patients even in insured and universal systems and is associated with non-adherence and worse survival. Validated instruments (COST-FACIT) exist, and financial navigation programmes have shown reductions in patient debt and distress in US trials. The proposal is to embed a short financial toxicity screen in routine patient-reported outcome collection at each cycle, with an automatic referral to a financial navigator and a data feed to payers documenting the burden by drug and regimen.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prices and value): Prasad, De Jesús & Mailankody, The high price of anticancer drugs: origins, implications, barriers, solutions (Nat Rev Clin Oncol 2017)","url":"https://doi.org/10.1038/nrclinonc.2017.31"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-drug-pricing","b-toxicity-qol"],"keyPapers":["paper-prasad-nat-rev-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Routine screening with navigation reduces the proportion of patients reporting severe financial toxicity by a third, reduces treatment non-adherence for oral oncolytics, and generates drug-level financial burden data that payers use in negotiations.","rationale":"Financial toxicity is a recognised adverse effect that is not measured, so it is not managed; the same logic that made pain a vital sign applies, and navigation interventions have randomised evidence of benefit.","test":"Cluster-randomised trial across 20 cancer centres of routine screening plus navigation versus usual care with financial toxicity score, adherence and out-of-pocket cost at 12 months.","maturity":"early-clinical","actor":"clinic","cost":"medium","horizonYears":3},"route":"/ideas/idea-reg-financial-toxicity-vital-sign/","neighbours":{"bottleneck":[{"id":"b-drug-pricing","kind":"bottleneck","name":"Prices and value","route":"/bottlenecks/b-drug-pricing/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-prasad-nat-rev-clin-oncol","kind":"paper","name":"The high price of anticancer drugs: origins, implications, barriers, solutions","route":"/key-papers/paper-prasad-nat-rev-clin-oncol/"}],"technology":[{"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/"},{"id":"rejuv-mind-distress-screening","kind":"technology","name":"Screening for distress: what the thermometer can and cannot do","route":"/technologies/rejuv-mind-distress-screening/"}],"roadmap":[{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","route":"/roadmaps/global-access-roadmap/"},{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}