The economics of cancer management

Breast cancer patients' out-of-pocket expenses

Patients with cancer soon discover that there is much more to the cost of treatment than hospital and physician bills. Out-of-packet expenses for transportation, food supplements, over-the-counter medications, distractions, telephone bills, insurance premiums--at a time when employment may be out of the question--can be a significant drain on family finances. Women with regional breast cancer reported their estimates of out-of-pocket expenses incurred during 1 month of outpatient chemotherapy. All women in the study were covered by some form of insurance. Mean monthly out-of-pocket costs were $360 (SD = $346), and ranged from $36 to $1224. Additional costs for wigs, special events, gifts, and alternative treatment incurred since diagnosis, ranged from $20 to $3700. These costs excluded expenses for health providers. Very low and very high expenditures may indicate risks concealed from providers that may have subsequent impact on long-term capacity to sustain treatment. Nurses can help families anticipate expenses and prioritize referrals to community agencies.