Treatment out-of-pocket cost communication and remote financial navigation in patients with cancer: a feasibility study

• Type of Material: Article
• Authors: Gelareh Sadigh, Emory University; Debrua Coleman, Emory University; Jeffrey Switchenko, Emory University; Judith O Hopkins, SCOR NCORP/Novant Health Cancer Institute; Ruth C Carlos, University of Michigan
• Language: English
• Date: 2022-07-07
• Publisher: SPRINGER
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
• Final Published Version (URL): http://dx.doi.org/10.1007/s00520-022-07270-5
• Title of Journal or Parent Work: SUPPORTIVE CARE IN CANCER
• Volume: 30
• Issue: 10
• Start Page: 8173
• End Page: 8182
• Grant/Funding Information: This work was supported by ECOG-ACRIN Cancer Care Delivery Research Pilot Grant. TailorMed Medical Inc. provided in-kind support including access to their price transparency and financial navigation platforms as well as an hour of remote financial counseling for the enrolled participants for free.; TailorMed and ECOG-ACRIN had no role in the design of the study; in the collection of surveys, analyses, or interpretation of data; in the writing of the manuscript; and in the decision to publish the results.
• Keywords: PILOT FEASIBILITY; Science & Technology; Health Care Sciences & Services; TOXICITY; Cancer; Out-of-pocket communication; PROVIDER; Rehabilitation; CARE; IMPACT; LIFE; Financial hardship; Life Sciences & Biomedicine; Oncology; Financial navigation; PRICE TRANSPARENCY; BURDEN

Abstract

Objective: We conducted a pilot study assessing the feasibility of a personalized out-of-pocket cost communication, remote financial navigation, and counseling (CostCOM) intervention in cancer patients. Methods: Twenty-three adult, newly diagnosed cancer patients at a single community oncology practice were asked to complete a survey and participate in a CostCOM intervention, including patient-specific out-of-pocket cost communication, remote financial navigation, and counseling. Feasibility was defined as patient participation in CostCOM, and its impact on financial worry measured using the Comprehensive Score for Financial Toxicity (COST) (higher score = less worry) was assessed. Eight patients’ and two providers’ experience with CostCOM was evaluated using qualitative interviews. Results: Mean patient age was 61 (78.3% female; 100% white). Of 23 CostCOM patients, 86.9% completed CostCOM, 60% of them completed a financial assistance application, and 25% of those who applied were enrolled in a co-pay assistance program. Patients’ financial worry significantly improved following CostCOM (COST score of 10.0 ± 9.6 at enrollment vs. 16.9 ± 8.1 at follow-up; p < 0.001). Mean general satisfaction (out of 5) with CostCOM was 4.1 ± 0.7. In qualitative interviews following OOPC communication, 75% felt a positive impact on their mental health, and all patients reported no change in their treatment plan; 83.3% found financial navigation beneficial. In providers’ interviews, buy-in from relevant stakeholders, integration of the CostCOM with existing workflow, and larger studies to assess the effectiveness of CostCOM were identified as factors needed for CostCOM implementation in practice. Conclusion: CostCOM interventions are feasible and acceptable and decrease financial worry in patients with cancer.