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Patient and oncologist discussions about cancer care costs

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Patient out-of-pocket costs are higher for cancer care than for any other health-care sector. Oncologist–patient discussions of costs are not well understood. We conducted an exploratory interview study to examine the frequency, patterns, attitudes, and preferences of both patients and providers on discussion of treatment costs.

Methods

We conducted semi-structured telephone interviews with oncology clinicians and people receiving chemotherapy at a large nonprofit health system. Multiple investigators conducted thematic analysis using modified content analysis, grounded theory, and interaction analysis methods.

Results

Patient themes included the relevance of cost to their experience, preference for the doctor to be the starting point of cost discussions, but relative infrequency of discussions with doctors or other care team member. Provider themes were an emphasis on clinical benefit above costs, conviction that cost-related decisions should rest with patients, and lack of access to treatment costs. Interest in discussing costs and barriers accessing cost information were common themes from both patients and providers.

Conclusions

Doctors and patients want to discuss treatment costs but lack access to them. These data support growing evidence for a provider role in discussions of cost during cancer treatment planning.

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Acknowledgments

This study was funded by the National Cancer Institute’s Cancer Research Network Across Health Care Systems (U19 CA79689). The authors also wish to thank Eric Chen, MD PHD (Chief, Medical Oncology, Group Health Cooperative) for his support and collaboration on all phases of this study.

Conflict of interest

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Authors and Affiliations

  1. Group Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA

    Nora B. Henrikson, Leah Tuzzio, Elizabeth Trice Loggers, Janice Miyoshi & Diana SM Buist

  2. Fred Hutchinson Cancer Research Center, Seattle, USA

    Elizabeth Trice Loggers

Authors
  1. Nora B. Henrikson
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  2. Leah Tuzzio
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  3. Elizabeth Trice Loggers
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  4. Janice Miyoshi
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Correspondence to Nora B. Henrikson.

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Henrikson, N.B., Tuzzio, L., Loggers, E.T. et al. Patient and oncologist discussions about cancer care costs. Support Care Cancer 22, 961–967 (2014). https://doi.org/10.1007/s00520-013-2050-x

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  • DOI: https://doi.org/10.1007/s00520-013-2050-x

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