In recent years, the medical field has called for more cost transparency to control rising costs, but cancer patients and oncologists are uncomfortable engaging in these discussions.
Those were the findings of a new study to be presented at the 2017 American Society of Clinical Oncology annual meeting next week in Chicago.
Researchers at Penn Medicine conducted interviews with 22 cancer patients and 19 physicians at Penn's Abramson Cancer Center and three of its affiliated community practices over the course of a year.
They found that the patients were afraid of being profiled based on their socioeconomic status or ability to pay. They were also concerned that it would distract the physician from their primary roles as health advocates.
The physicians feared that cost transparency would hinder the relationship with their patients by exposing personal or institutional financial conflicts of interest. Time constraints and the challenge of providing accurate cost estimates were other hurdles.
The research also found that strong doctor-patient relationships and the availability of support staff with financial expertise were were helpful in facilitating cost transparency discussions.
This poses an issue as financial burdens become more of the patients' responsibility, according to Dr. Erin Aakhus, first author of the study. The high out-of-pocket costs can negatively affect patient adherence and lead them to discontinue treatment too early.
Oncologists are being encouraged to discuss these costs in terms of copayments, coinsurance and deductibles based on the patients' insurance plans, to help them avoid financial difficulties or choose higher-value care.
The researchers concluded that oncology practices will need to consider all of the barriers to cost transparency. That will help them to develop a framework for physicians and their staff.
"In future studies, we hope to use this framework to develop and test practical, scalable interventions that improve communication about costs between patients and their providers," said Aakhus.
