Defining the clinician's role in mitigating financial toxicity: an exploratory study

Support Care Cancer. 2021 Aug;29(8):4835-4845. doi: 10.1007/s00520-021-05984-6. Epub 2021 Feb 5.


Background: Financial toxicity describes the financial burden imposed onto patients by a cancer diagnosis and is a growing concern. Many clinicians do not currently address financial toxicity despite patients' desire for them to do so. Current literature explores physicians' perspectives but does not clearly define an actionable role clinicians can take to address financial toxicity. We sought to fill this gap by first assessing clinicians' perspective on their role in alleviating financial toxicity at our institution. We subsequently aimed to identify current barriers to mitigating financial toxicity and to garner feedback on clinician-oriented interventions to address this growing problem.

Methods: We developed an 18-item electronic, anonymous survey through Redcap. We invited all oncology clinicians including attending physicians, advance practice providers, and trainees at our institution to participate.

Results: A total of 72 clinicians (30%) completed the survey. The majority agreed that clinicians have a role in addressing cost. The top three barriers to discussing cost with patients were knowledge of out of pocket costs, time, and awareness of resources. Less than half of respondents used an existing comparative cost tool to incorporate cost consciousness into treatment decisions. The most desired intervention was an institutional resource guide. In open-ended comments, the most common barrier described was transparency of out of pocket costs, and the most common solution proposed was a multi-disciplinary approach to addressing financial concerns patient face.

Discussion: Improving price transparency, incorporating existing resources into clinical practice, and streamlining multi-disciplinary support may help overcome barriers to addressing financial toxicity.

Keywords: Cost of care; Cost-effectiveness; Financial toxicity; Health services research.

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Physicians / economics*
  • Surveys and Questionnaires