Clinical trial NCT06771739: A Pilot Unrestricted Payment Program for Early-stage Cancer Patients: the PAYMENT Trial
Official title: Preventing Financial Adversity Among Early-Stage Cancer Patients Through Unrestricted Cash (PAYMENT) Pilot Study
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Malignant Solid Neoplasm
Lead sponsor: Fred Hutchinson Cancer Center
Sponsor class: OTHER
Collaborators: name: National Cancer Institute (NCI)
name: Oregon Health and Science University
name: SWOG Cancer Research Network
First posted: 2025-01-13
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This clinical trial studies whether an unrestricted cash payment program can be used to improve financial and clinical outcomes in early-stage cancer patients with financial concerns. A cancer diagnosis can have poor financial outcomes, and the cost of cancer treatment can lead to high medical debt and financial hardships for the patient and family. Financial hardship during cancer treatment is associated with adverse outcomes including poorer quality of life, lower treatment compliance, more aggressive use of hospital-based care, and worse survival. Newly diagnosed cancer patients with financial concerns may avoid treatment entirely so that they can continue to work and maintain income, provide for their families, or pay rent. An unrestricted cash payment program provides patients with a preloaded cash card once monthly. The patients can choose what to use the card to pay for and may include items like food, rent, or utilities. This provides a period of guaranteed income for the patients and may prevent them from falling into poverty and improve financial and clinical outcomes.

Detailed description: OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive a $1000 preloaded cash card once monthly for 3 months.

ARM B: Patients receive a $100 preloaded cash card once monthly for 3 months.

After completion of study intervention, patients are followed up 3 months and 6 months post randomization.

Eligibility criteria: Inclusion Criteria:

* Age \>= 18
* Ability to understand English
* Ability to understand and willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants
* Within 90 days of a non-metastatic or early-stage solid tumor receiving or rescheduled to receive treatment in the neoadjuvant, adjuvant or definitive setting for curative intent. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
* Current cancer patient at PeaceHealth (Southwest Medical Center or St. Joes)
* Not current Medicaid enrollee
* Not enrolled in hospice
* Screens positive for financial fragility

Primary outcomes:
measure: Participant enrollment
timeFrame: Up to 1 year
measure: Time to accrue 20 patients
timeFrame: Up to 1 year
measure: Dropout rate
timeFrame: Up to 1 year
measure: Survey completion rate
timeFrame: Up to 1 year
Secondary outcomes:
measure: Financial hardship
timeFrame: Baseline, 3 and 6- months post randomization
measure: Treatment nonadherence
timeFrame: Baseline, 3 and 6- months post randomization
measure: Unplanned emergency department (ED)/hospital admissions
timeFrame: Baseline, 3 and 6- months post randomization
measure: Food and housing insecurity
timeFrame: Baseline, 3 and 6- months post randomization
measure: Quality of life
timeFrame: Baseline, 3 and 6- months post randomization
Other outcomes:
Locations:
city: Bellingham
country: United States
facility: PeaceHealth Saint Joseph Medical Center
state: Washington
city: Vancouver
country: United States
facility: PeaceHealth Southwest Medical Center
state: Washington
Study officials:
affiliation: Fred Hutch/University of Washington Cancer Consortium
name: Veena Shankaran, MD
role: PRINCIPAL_INVESTIGATOR
References: