Understanding cancer survivor cost communication experiences and preferences

Although cost discussions between cancer patients and their oncology providers are associated with lower out-of-pocket costs, patient experiences and preferences surrounding these conversations are relatively unexplored.

This qualitative study, conducted March-April 2022, assessed patient-provider cost communication in a convenience sample of cancer survivors aged 26-60 and less than 5 years from diagnosis. Semi-structured interviews were recorded, transcribed, and coded using iterative content analysis to identify emerging patterns and themes.

Survivors (N = 20) were 65% female and 75% non-Hispanic White with a median diagnosis age of 47.5 years. Main themes included survivor cost conversation experiences and preferences, with subthemes such as cost information seeking, advantages and disadvantages of cost discussions, and optimal timing for financial discussions. Most patients (65%) preferred to discuss costs before initiating cancer treatment but after a cancer diagnosis. One patient shared, "Not at diagnosis. That is the most devastating time of your life…" Most survivors (90%) wanted family involved in cost conversations for ease of understanding and recollection. When asked whether their oncologist should consider out-of-pocket costs during treatment planning, 60% of survivors preferred their oncologist to consider costs to aid patients in financial planning, avoiding unexpected expenses, and decreasing stress/anxiety.

Patient preferences regarding cancer treatment cost-related communications are highly individualized. Information on how to assess patient cost communication preferences during cancer care delivery is needed to address cost-related challenges facing cancer survivors.