Abstract P2-12-03: The financial costs of metastatic breast cancer and the decisions patients make to cope with costs: Findings from the Cancer Experience Registry
Authors: Buzaglo Joanne , Morris Anne , Miller Melissa , Harvey Allison , Golant Mitch 
Published: May 2015

Abstract
Background: An estimated 155,000 people are living with metastatic breast cancer (MBC) in the US. With new developments in treatment, people are living longer with MBC and have to manage greater financial burden related to care, including copays and out of pocket costs.
Methods: Since March 2013, the Cancer Support Community has registered 909 people living with MBC to the Cancer Experience Registry, an online initiative designed to raise awareness about the psychosocial impact of cancer. 496 registrants responded to questions about the financial cost of MBC. This sample was 99% female, 91% Caucasian, and 69% with a college degree and median age 56. Median time since MBC diagnosis was 3 years.
Results: 38% of registrants report being seriously or very seriously concerned about health insurance or money worries and 46% reported currently experiencing intrusive ideation about the financial cost of care. Registrants reported experiencing a significant burden from MBC related expenses, as shown in the table below.
Please tell us how much of a burden the following additional expenses caused you. (0=not at all to 4=very much)n≥3 (%)copays for medical treatments (e.g., surgery, chemotherapy, radiation, etc.)49246.1Prescription drugs and over the counter medication (including co-pays)49240.9Copays for medical appointments/visits49239.3Diagnostics or treatment not covered by insurance49239.7Complementary medicine or alternative therapy (e.g., vitamins, homeopathy)49137.9Travel (parking, gas)48920.6Medical supplies48921.3Late fees on bills49219.6Counseling or therapy48819.9
Because of these expenses, registrants have: foregone vacations, celebrations, and social events (53%); sold property (12%); refinanced their house (13%); filed for bankruptcy (5%); downsized their living accommodations (16%); liquidated their assets (19%); depleted their savings (40%); borrowed against or used money from a retirement plan (27%); cut their grocery expenses (42%); applied for or used public assistance (14%); chosen a treatment that is not as effective but costs less (9%); asked their doctor if there was a less expensive treatment (19%); tried to negotiate payments with credit companies (24%); negotiated with service providers to reduce costs (22%); used pharmaceutical assistance programs (26%); accepted money from friends or family (39%); and cashed in a life insurance policy early (8%), among others. In order to reduce the cost of treating MBC, registrants often or always postpone seeking psychological counseling or support (20%) and delay follow up on recommendations for complementary treatment such as physical or occupational therapy and nutrition counseling (13%).
Conclusion: MBC places a significant financial burden on patients, which can result in patients taking measures that can significantly impact their quality of life. Future implications for research include the development and evaluation of interventions designed to enhance doctor-patient communication and support (e.g., financial counseling) to ensure that the financial cost of MBC does not negatively impact the patient’s quality of life, course of cancer care, and health outcomes.
Citation Format: Joanne Buzaglo, Anne Morris, Melissa Miller, Allison Harvey, Mitch Golant. The financial costs of metastatic breast cancer and the decisions patients make to cope with costs: Findings from the Cancer Experience Registry [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-12-03.