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Navigating the Costs of Cancer Care

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Published on June 11, 2020

Financial navigators Dan Sherman and Aimee Hoch take audience questions on the complex challenges cancer patients face; from juggling living expenses and treatment costs, insurance coverage, to coping with financial stress.

Watch as they discuss financial assistance available for those facing hardship or unemployment, and how clinical trial participation can benefit patients. 

Watch Parts 1 through 3 of this series at How Can I Find a Financial Navigator?Is Financial Help Available for Cancer Patients? and Financial Assistance for Cancer Patients

This program is sponsored by Incyte, Janssen and Pharmacyclics. These organizations have no editorial control, and Patient Power is solely responsible for program content.

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Transcript | Navigating the Costs of Cancer Care

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Recorded on June 4, 2020

Andrew Schorr:

Okay. Dan, let me fire a question for you that just came in from the audience. So let's see, I'm going to read it. What if I have my own insurance that my employer has been reimbursing me for, but now I'm unemployed and can't afford to keep paying it, yet I'm already in treatment, and I've already met my out of pocket. What do you do?

Dan Sherman:

There would have to be an analysis of his diagnosis, and then to see if there is, they're called Copia Systems Foundations to see if one of those organizations can be of assistance. Sort of, if he is in treatment and receiving some type of a pharmaceutical product that's expensive, odds are fairly high that there will be a program out there. It's not guaranteed, but that analysis would need to occur.

Andrew Schorr:

Okay. And sometimes there are free drug programs, right, for people who need a certain cancer treatment, and otherwise there's no way they can afford it?

Dan Sherman:

Right. Yeah, there are certainly are, and so that would put a nice Band-Aid on the sore. If they need access to one specific drug, that, that patient can easily get free drug from the pharmaceutical company if they've lost their insurance. My heart, and I think Aimee would agree here, that we're always trying to see if we can save that insurance for them because cancer patients receive so many more treatments and appointments than just that drug, and we want to try to protect that.

Andrew Schorr:

Let's talk about food. If I lost my job, Aimee, I'm having trouble paying for everything, and if I have a cancer diagnosis on top of that, obviously, I want to live, but I want to feed my family and feed myself. Are there programs to help with those kind of basic costs, maybe even my rent. What do we do then?

Aimee Hoch:

Generally, those programs are more local programs, so Dan might have different ones than I have. There are some federal programs, and there were a few programs that came out because of the pandemic. They have some small gift cards available that you could use for gas or groceries, and I've accessed quite a few of those for patients in conjunction with our assessment and all of the other things that we're doing for them. You also could look at your local food banks. I'm sure that you're also probably partnering with the social worker of your cancer program, and they could have some input on that too, but we have helped people with some temporary help with their household bills for one month through some local organizations here in our area. Those great gift cards from those foundations that I mentioned. So there are definitely some programs out there. We like to take those programs too and complement all of the other things that we're doing.

Andrew Schorr:

Dan, let's talk about all of this in the context of like your medical center. This is bewildering, and I think Aimee was mentioning earlier, and you've mentioned it many times before, a cancer diagnosis is one of the most stressful things you could ever face for you or a loved one, and then you have the financial worries that go with it. Then you add now the pandemic, and you’re worried about your overall health. Does the financial navigator work as part of the healthcare team? Maybe if you're the financial navigator, could there be a social worker involved? Could there be even sometimes a psychologist or a physician who deals with anxiety or depression, because the patient is feeling like the world is crushing in? What would you say?

Dan Sherman:

Absolutely. Now, once again, it depends on the specific cancer center that you're going to, but more and more programs across the United States are really paying attention to this and they have invested into mental health services. Sometimes it's the social worker, sometimes they have psychologists on staff that can assist patients. I would argue though that when it comes to the stress that patients feel or experience due to the financial part, all the social work interventions in regards to therapy is not going to solve that problem, and so it's just critical that there is somebody in place that actually can address the issues and attempt to fix the issues. That resolves the anxiety for a lot of patients. Now, I don't want to take that away—social workers are extremely important, so there are lots of mental health issues related to cancer which needs to be addressed by mental health professionals. But the mental health stress experience due to financial reasons, I have just personally found that you need to solve that problem, and to get the right people in to do that.

Andrew Schorr:

Aimee, here's a question that came in from the audience, said, "Okay, well, this is great what you're offering to help navigate. How do you get paid?" Does the person with the financial concern, for you, I guess, as an employee of Grand View Health, is that a service, or do they have to pay you some kind of fee?

Aimee Hoch:

Where I'm located at Grand View Health, it's part of their service. It's part of the treatment team, they do not pay for my services.

Andrew Schorr:

And is that typical that if there’s somebody on staff, it's part of the team?

Dan Sherman:

Correct. Yep, because, obviously, the focus of a healthcare system is to heal patients. This is part of the process of healing our patients. When they go through cancer care, we know that financial toxicity hits many of them, and we have to pay attention to those. This is, obviously, a win for the patient, but if you think about it, it's also a win for the provider. It's helpful for the provider that their patients are healthy and have less stress. Their outcomes are better. They are able to tolerate treatments better. They're more compliant with treatment. So it's a win for the patient, but it's also a win for the provider.

Andrew Schorr:

I just want to bring up one thing we haven't talked about before. We were doing a program actually earlier today with some cancer clinicians, but they're also researchers at major centers. There's the thinking that if I'm in a clinical trial, which are starting to happen again in oncology, that certain things will be free, but certain things won't be. Dan, can you talk about that a little bit—obviously, somebody should decide with their doctor what's the right thing to do clinically for them, but is the benefit of being in a clinical trial that certain services or medicine will be free, but not everything?

Dan Sherman:

I was hoping you were going to ask Aimee that question then. Now, Aimee, feel free to jump in, because I think this is a big hurdle for financial navigation services, is the whole clinical trials component. Now, with that said, many of the clinical trials that patients go through, the products are provided for free, and so they shouldn't be burdened with a financial hardship because they’re going through a clinical trial. But sometimes then other treatments that they were receiving, so if they're coming in for a clinical trial for chemotherapy, and that trial requires, well, you need to have a CAT scan every two months, sometimes we have a hard time to get the insurance company to cover some of those treatments. Those are important questions for patients to be asking when they're going in, and they've been approached about a clinical trial, but in general, and, Aimee, feel free to jump in here, but in general, the products for the clinical trial is provided for free. So that could be a huge benefit for patients.

Andrew Schorr:

Aimee, any comment from you?

Aimee Hoch:

I agree with Dan. Usually, the products and the medication that they're taking is provided for free, and then some of the services that go along with it are, but there are some—they might have appointments locally for another treatment, or they might need follow up for blood work, and if that's not covered, we need to look at all of that. And then if they're getting their clinical trial at a center that's maybe not their local center, and they're traveling for that, travel costs can become an issue there too. So we access some of those programs that I mentioned to you earlier, foundations, and sometimes they can help with that.

Andrew Schorr:

Thank you both for being here; Dan Sherman in Grand Rapids, and Aimee Hoch outside Philadelphia. Thanks. We'll let you go.

Aimee Hoch:

Thank you.

Dan Sherman:

Thank you.

Andrew Schorr:

We really appreciate. I'm Andrew Schorr, as I like to say, remember, knowledge can be the best medicine of all. Take care.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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