Platter Heather N, Vanderpool Robin C, Davidoff Amy J, de Moor Janet S, Williams Courtney P
Department of Public Health Science, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA.
Support Care Cancer. 2025 May 5;33(6):450. doi: 10.1007/s00520-025-09506-6.
Although cost discussions between cancer patients and their oncology providers are associated with lower out-of-pocket costs, patient experiences and preferences surrounding these conversations are relatively unexplored.
This qualitative study, conducted March-April 2022, assessed patient-provider cost communication in a convenience sample of cancer survivors aged 26-60 and less than 5 years from diagnosis. Semi-structured interviews were recorded, transcribed, and coded using iterative content analysis to identify emerging patterns and themes.
Survivors (N = 20) were 65% female and 75% non-Hispanic White with a median diagnosis age of 47.5 years. Main themes included survivor cost conversation experiences and preferences, with subthemes such as cost information seeking, advantages and disadvantages of cost discussions, and optimal timing for financial discussions. Most patients (65%) preferred to discuss costs before initiating cancer treatment but after a cancer diagnosis. One patient shared, "Not at diagnosis. That is the most devastating time of your life…" Most survivors (90%) wanted family involved in cost conversations for ease of understanding and recollection. When asked whether their oncologist should consider out-of-pocket costs during treatment planning, 60% of survivors preferred their oncologist to consider costs to aid patients in financial planning, avoiding unexpected expenses, and decreasing stress/anxiety.
Patient preferences regarding cancer treatment cost-related communications are highly individualized. Information on how to assess patient cost communication preferences during cancer care delivery is needed to address cost-related challenges facing cancer survivors.
尽管癌症患者与其肿瘤学提供者之间的费用讨论与较低的自付费用相关，但围绕这些对话的患者体验和偏好相对未被探索。
这项定性研究于2022年3月至4月进行，在年龄在26 - 60岁且确诊后不到5年的癌症幸存者便利样本中评估患者与提供者之间的费用沟通。使用迭代内容分析对半结构化访谈进行记录、转录和编码，以识别新出现的模式和主题。
幸存者（N = 20）中65%为女性，75%为非西班牙裔白人，中位诊断年龄为47.5岁。主要主题包括幸存者的费用对话体验和偏好，子主题如费用信息寻求、费用讨论的优缺点以及财务讨论的最佳时机。大多数患者（65%）倾向于在开始癌症治疗前但在癌症诊断后讨论费用。一名患者分享道：“不是在诊断时。那是你生命中最具毁灭性的时刻……”大多数幸存者（90%）希望家人参与费用对话，以便于理解和回忆。当被问及他们的肿瘤学家在治疗计划期间是否应考虑自付费用时，60%的幸存者希望他们的肿瘤学家考虑费用，以帮助患者进行财务规划、避免意外开支并减轻压力/焦虑。
患者对癌症治疗费用相关沟通的偏好高度个性化。需要有关如何在癌症护理过程中评估患者费用沟通偏好的信息，以应对癌症幸存者面临的与费用相关的挑战。
