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Comment & Response
December 3, 2020

Parking Costs—A Family Affair—Reply

Author Affiliations
  • 1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
  • 2New York University Grossman School of Medicine, New York, New York
  • 3Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Oncol. 2021;7(2):307. doi:10.1001/jamaoncol.2020.6368

In Reply We thank Drs Ramagopalan and Sammon for their comments regarding our study on parking fees at National Cancer Institute–designated cancer centers1 and want to underscore their point that financial toxicity driven by indirect costs is not isolated to the US. A study from Australia found that nonmedical costs for those in rural areas were primarily driven by travel and totaled more than $800 (US) in the first 6 months of cancer treatment.2 Another study from Iran found that patients with cancer travel on average 282 miles (455 km) to receive care at the National Cancer Institute, which increases the burden on patients and caregivers.3

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