Financial toxicity and the economic cost of breast cancer therapy

Abstract

: Breast cancer. given its natural history, can be present for many years resulting in significant cost to insurers as well as patients with costs not covered by the patients’ insurance plans. Breast cancers tends to be diagnosed in the most productive times of a patient’s life disrupting both family life and employment. Because of the dependence on employment-based insurance coverage, financial toxicity has entered the lexicon of care of patients with breast cancer. Objective measures of toxicity include costs not borne by insurance companies while subjective measures of toxicity include the psychological stress of having to deal with having to deal managing a household budget and determining which bills to pay. Costs not covered by insurance companies such as child care and travel to and from treatment appointments can add to the psychological stress patient’s encounter. Insurance, income and insurance status all play a role in financial toxicity. Unfortunately, financial toxicity is not limited to only those countries without some form of universal health insurance coverage. Financial discussions will need to occur between patients and caregivers in the future as cost of care increases. A switch to a tax-funded universal healthcare system with a universal set of benefits may be needed to decrease the incidence of financial toxicity in women with breast cancer.