Cancer patients out of pocket up to $22,000

Cancer patients are paying up to $22,000 in out-of-pocket expenses due to high medical fees, according to a research letter published by the Medical Journal of Australia. Lower medical fees and greater transparency would reduce the financial burden of people battling cancer.

Current information on the out-of-pocket costs incurred by Australians being treated for cancer is limited, according to the authors from QIMR Berghofer Medical Research Institute, led by Associate Professor Louisa Gordon.

Using data from 452 participants in the QSkin Sun and Health Study, linked with Medicare data, the researchers were able to identify all services for consultations, tests, imaging, procedures and medications billed through the Medicare system.

“Over 2 years, total provider fees were highest for those with lung (median, $22,011) or breast cancer (median, $21,581) and lowest for those with melanoma (median, $5,248),” Gordon and colleagues wrote.

“However, median out-of-pocket expenses were highest for patients with breast ($4,192) and prostate cancer ($3,175) and lowest for participants with lung cancer ($1,078). The median proportion of provider fees covered by Medicare subsidies was 63%. The median out-of-pocket costs [across the five cancers studied] were largest for therapeutic procedures ($670), professional attendances ($414) and medications ($288). The median provider fee was $9,821; the median Medicare subsidy was $6,280.

“Medical costs for patients with some types of cancer are high; one-quarter of these cancer survivors paid upfront doctors’ fees of more than $20,000 over 2 years.” The consequences, they wrote, could be devastating for individuals experiencing financial hardship, including serious impacts such as “delays of or non-adherence to therapy and increased morbidity”.

Difficulties in predicting what co-payments were likely to be requested during cancer treatment was a big problem, they wrote.

“The private health insurance rebate for the privately insured (costing $6.5 billion per year) together with the Medicare benefits paid mean that the federal government continues to make substantial payments for insured individuals, money that might otherwise be re-directed to strengthen the public health system,” Gordon and colleagues concluded.

“Practical solutions for alleviating the financial burden on patients with cancer would include lower medical fees and greater transparency in charging.”

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