The financial toxicity of cancer is growing. Here’s how we reduce it

Cancer drains individuals of their physical, emotional, and financial health. Given the impact on each patients and the people of their lives — including their employer — it is time that CEOs take note and take motion to scale back the burden of cancer.

In a study from the American Cancer Society Cancer Motion Network, nearly half of cancer patients and survivors reported being extraordinarily burdened by medical debt. Many respondents carried a negative balance of a minimum of $5,000 from their cancer treatment for multiple 12 months, and 42% of individuals with cancer deplete their life savings throughout the first two years after diagnosis.

Financial hardship attributable to cancer can even contribute to “financial toxicity,” wherein the associated fee of treatment forces individuals to make tradeoffs that impact their probabilities of survival. These may include non-biologic aspects akin to skipping or halving cancer medications to stretch their supply, or being unable to finish cancer care as planned as a result of the high costs of transportation to or housing near cancer treatment centers. This model is not sustainable, and rising costs of recent, life-saving cancer therapies will impose additional financial toxicities — and an increasingly large threat to patients’ lives.

Not only does financial toxicity of cancer care affect the person, it may also negatively impact their employer. Because the providers of medical health insurance coverage for nearly half the country, employers and unions shoulder much of cancer’s financial burden. Today, cancer is the leading health-care cost for mid- and large-sized organizations within the U.S., and the burden is growing.

For the primary time in history, greater than 2 million Americans will receive a latest cancer diagnosis in 2024. While increasing cancer incidence will be attributed partly to our aging population (cancer risk increases with age), we also see a disturbing national trend by which younger individuals are being diagnosed with 17 major cancers. These are individuals who would still likely be within the workforce, using employer-sponsored medical health insurance. Because of this, employers are asking what they will do to scale back the burden of cancer on their populations — and their bottom line.

Patients, families, and employers all “win” when cancers are diagnosed at an early stage. Detecting cancer early not only improves probabilities of survival, it significantly lowers the associated fee of care. Overall, treatment costs for somebody diagnosed at stage IV — when cancer has spread throughout the body — are a mean of $156,000 higher than for those diagnosed at stage I, when the disease is localized. The primary 12 months of treatment for colorectal cancer, which affects over 150,000 individuals annually in the USA and is on the rise in younger populations, costs a mean of $111,000 when diagnosed at stage I, with a few 90% five-year survival rate. In contrast, stage IV colorectal cancer drives average treatment costs of $256,000 in the primary 12 months, and five-year survival rates are under 20%. Evidence suggests that if individuals could only benefit from the prevention, early detection, and cancer treatment strategies that exist today, the cancer mortality rate would decline by 30% to 50%.

These statistics are profound and strongly suggest that concerted efforts from employers and individuals to encourage cancer prevention and early detection would improve health and reduce health-care costs. Today, our greatest tool to attain that is screening. Adherence to beneficial screening guidelines — like those published by ACS — could save the U.S. health-care system $26 billion per 12 months in avoided treatment costs.

Despite the importance of early detection and proven value of screening, access to preventive care stays a barrier to raised outcomes. At present, a staggering 65% of eligible Americans are out-of-date with beneficial cancer screenings. Covid-19 restrictions delayed or prevented 9.4 million cancer screenings in 2020 alone, likely resulting in later-stage diagnoses that might have normally been caught earlier.

There are also logistical and societal barriers that contribute to financial toxicities and impact an individual’s ability to get screened. People might have to take day off work or arrange childcare to attend a screening appointment. They might must weigh potential future treatment costs against their must pay rent. Some will not be aware they’re eligible for screening, and stigma and fear related to cancer screening hinders some people from looking for care. Inequities based on one’s socioeconomic status — including where they live, their income, education level, access to healthcare and healthy foods, and other social determinants of health — create roadblocks to preventive care. To comprehend the advantages of early detection on individuals and organizations, it is vital that we develop latest strategies to remove these barriers.

ACS is committed to tackling cancer, approaching the challenge of improving access to care and reducing financial toxicity from multiple angles. Similar or supportive motion from U.S. employers will increase our collective impact against cancer’s burden.

Toward the goal of accelerating early detection, ACS recently partnered with Color Health in a three way partnership to enhance access to screening and preventive care through employers and unions. By making it easier and more convenient for workers to get care — with at-home testing kits and care navigation support across their cancer journey — this program goals to extend awareness, accessibility, and affordability of cancer screening and early detection. Notably, organizations making the most of the ACS-Color program have witnessed a 77% increase in cancer screening adherence.

Along with direct screening initiatives, programs like Road to Recovery and ACS Hope Lodges remove the associated fee burdens of transportation and lodging for cancer treatment. Other partnerships through BrightEdge, ACS’s donor-funded innovation and investment arm, provide access to a big selection of solutions that help people navigate the financial complexities of cancer across the continuum of care. One BrightEdge portfolio company, TailorMed, offers a platform to assist patients find resources to cover the associated fee of treatment and reduce out-of-pocket expenses. Further investments aim to bring the patient voice into therapy and diagnostic development, to enable a future generation of sustainable cancer innovations that reduce patients’ financial distress.

Advocacy can also be key to reducing financial toxicity. ACS’s Cancer Motion Network advocates for Medicaid expansion to assist currently uninsured individuals access screening and preventive care. To bring down the associated fee of prescribed drugs, ACS CAN has also successfully advocated for “smoothing,” a policy that permits Medicare beneficiaries to opened up their prescription drug costs over the course of the 12 months. By making payments more manageable for patients, we remove a vital element of the cancer financial challenge.

Cancer will impact one in two women and one in three men in some unspecified time in the future of their lifetime. By facilitating guideline-recommended screening and activating programs that make early detection reasonably priced and accessible, employers can offset financial toxicities and improve outcomes for people across the country. When employers help their employees get screened, they carry us one step closer to ending cancer — and its costs — as we comprehend it.

—By Karen Knudsen, CEO of the American Cancer Society (ACS) and the American Cancer Society Cancer Motion Network (ACS CAN). She can also be a member of the CNBC CEO Council.