Rural cancer patients hit with major out-of-pocket expenses

Rural Western Australian cancer patients experience significant out-of-pocket expenses during cancer treatment according to a new study by researchers at The University of Western Australia.


The study surveyed 400 people diagnosed with breast, lung, colorectal or prostate cancer from four rural regions of WA (Great Southern, Goldfields, South West and Mid West) about five months after their diagnosis, as part of a bigger study investigating the cost of cancer treatment.


Of the 387 participants who reported their costs, 94 per cent experienced out-of-pocket expenses with an average cost of $2179 per person.


The majority of out-of-pocket expenses were attributable to surgery (22 per cent), diagnostic tests (20 per cent) and to travel-related expenses such as accommodation (12 per cent) and fuel (8 per cent).


About one in 10 participants experienced ‘catastrophic’ spending on health care, which is defined as spending more than 10 per cent of annual household income on treatment. Participants who were most likely to experience higher totalout-of-pocket expenses were younger than 65 years, lived outside the South West region of WA and had private health insurance.


Participants reported medical out-of-pocket expenses incurred for treatments, doctors’ appointments, tests, supportive care, and medications; and non-medical,out-of-pocket expenses related to accessing and managing cancer treatment such as travel, fuel, accommodation, parking, clothes, additional utilities costs, and complementary and alternative medicine.


Lead researcher Jade Newton, research assistant at UWA’s Cancer and Palliative Care Research and Evaluation Unit, said the most surprising findings were that private health insurance was associated with both higher medical and non-medical costs.


“We also found that prostate cancer patients were spending much more on treatment than patients with other diagnoses,” Ms Newton said.


“Given the already significant physical and emotional burden cancer can cause, we can hopefully better understand how these costs impact patients to develop appropriate interventions and ensure financial stress is not an element of a cancer diagnosis causing preventable distress.”


Professor Christobel Saunders, Professor of Surgical Oncology at UWA and Head of UWA’s Division of Surgery, has been a driving force behind the study, supported by the Cancer Council of Western Australia and Western Australian Government Department of Health through the WA Cancer and Palliative Care Network.


“This study showed that living in the South West of WA was a significant predictor of lower non-medical and total out-of-pocket expenses,” Professor Saunders said.


“The opening of a Comprehensive Cancer Centre in the region, which provides specialised surgery, chemo and radiation therapy, has most likely contributed to reduced non-medical expenses.


“Participants who were working before being diagnosed had significantly higher non-medicalout-of-pocket expenses compared to those who were not working.”


Dr Neli Slavova-Azmanova, research associate at UWA Medical School’s Cancer and Palliative Care Research and Evaluation Unit, said that with about 11 per cent of cancer patients reporting ‘catastrophic’ spending on health care, further research was urgently needed to work out exactly how badly rural cancer patients were financially affected and to minimise the impact.


14 May 2018.