Author Affiliations: Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
The direct medical costs of cancer have increased substantially in the past 2 decades. By one set of estimates, expenditures increased from about $27 billion in 19901 to more than $90 billion in 2008,2 a more than 2-fold increase even after adjusting for inflation (Figure). The high cost of cancer treatment often leads to financial hardship for patients and their families, including those with health insurance. Median out-of-pocket medical spending was more than $1500 in 2003-2004 for privately insured adults with cancer, and 10% of those had out-of-pocket costs exceeding $18 000.3 In a 2006 survey of adults in households affected by cancer, almost a quarter of insured respondents reported using most or all of their savings during treatment, and a similar proportion said their insurance plan paid less than expected for a medical bill.4 Although more than 4 out of 5 oncologists report that their concerns regarding patients' out-of-pocket spending influence their treatment recommendations, less than half say that they routinely discuss financial issues with their patients.5
Elkin EB, Bach PB. Cancer's Next FrontierAddressing High and Increasing Costs. JAMA. 2010;303(11):1086-1087. doi:10.1001/jama.2010.283