Best practices for discussing cancer costs with patients: 3 oncology leaders weigh in

The rising cost of cancer care is placing a large burden on patients and their families, some of whom lack access to quality health insurance and struggle to keep up with out-of-pocket costs. As a result, cancer care costs have become a critical component of patient-provider discussions.

A panel of oncology leaders discussed cancer care and drug costs during an Aug. 25 session at the Becker’s Oncology Virtual Summit. Panelists included:

• Sharla Gayle Patterson, MD, breast surgical oncologist and medical director at NCH Healthcare System’s Center for Breast Health in Naples, Fla.
  
• Jennifer Hansen, MSN, RN, service line director of cancer quality at Stanford (Calif.) Health Care
  
• Latanya Dean, PharmD, assistant director of hematology/oncology pharmacy services at Stanford Health Care

Here are three excerpts from their conversation, lightly edited for clarity. To view the full session on-demand, click here.

Question: What are some best practices for effective patient-provider conversations about cancer care costs? 

Dr. Patterson: When I talk about costs with my patients, those conversations aren’t limited to just the treatment at the moment of diagnosis. We are very much focused as a cancer community on what we call survivorship. From the day of diagnosis, we know that there’s going to be therapies and treatments for the entire lifetime of that patient. So the conversation has to expand beyond current treatments today, this month, or even this year. What is their ability to work going to be? What is their income going to be? What is their ability to participate in things that provide revenue to their family structure? It’s a much more complicated conversation than it used to be.

Ms. Hansen: We need to make sure we’re not just asking patients about nausea and neuropathies, but asking them about their financial concerns and what the entire continuum of care is going to look like for them in terms of costs. Also, it’s important to set really good expectations with the patient. So not just saying, “We have this great new treatment on the horizon, I think you’re a great candidate for it.” And then a week later the patient is told that their insurance company denied it. So kind of setting those expectations in the room with the patient. And then lastly, I think we need to have better conversations overall with patients about their prognosis, long-term expectations and survival, and what things are going to look like as their condition progresses, so that they have the ability to plan for the future.

Dr. Dean: From the pharmacy point of view, we often work with nursing at the infusion clinic to have conversations with patients on the spot. I think that it would be very advantageous to have those conversations further up the chain and give the patient a chance to actually absorb some of the information, because it’s a lot. We have patient navigators that work with our patients throughout their care journey, but I think it can be a little bit disjointed at times. For instance, a navigator and reimbursement specialist may have seperate conversations with the patient about cost. Stanford is making strides to improve that process, but I definitely think it’s a process that we need to improve fairly quickly given the impact it has on our patients

Source: BeckerHospitalReview By: Mackenzie Bean

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