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Cancer treatment can bankrupt patients even with insurance. Financial navigation programmes screen for money problems and connect patients to assistance, insurance optimisation and legal help, and trials show they reduce distress and debt.
'Financial toxicity' (Zafar 2013) describes the material, psychological and behavioural harm of cancer costs: ~40% of US patients deplete savings within two years (Gilligan 2018) and cancer patients are 2.65 times more likely to declare bankruptcy, which itself predicts mortality (Ramsey 2016). Drivers: high drug prices, cost-sharing, lost income, travel. Measurement: COST-FACIT. Interventions: proactive screening, financial navigators/counsellors (Lentz, Banegas), pharmaceutical assistance programmes, medication cost conversations, and policy (Inflation Reduction Act cap on Part D out-of-pocket costs from 2025; Medicaid expansion). Randomised and pragmatic trials (CAFÉ, 2024) show reduced financial distress and increased assistance uptake. Globally, catastrophic expenditure affects most cancer households in LMICs (ACTION study, Southeast Asia).
Treat cost as a side effect: screen routinely, quantify with validated tools, and assign trained staff to reduce out-of-pocket exposure through benefits, assistance programmes and treatment choices with equal efficacy and lower cost.
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One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
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