NCI has awarded a four-year, more than $1.87 million grant to University of North Carolina Lineberger Comprehensive Cancer Center researchers to study the impact of implementing financial navigation services at five rural cancer centers in North Carolina to help patients cope with the financial burden, or financial toxicity, related to cancer care.
Building on pilot studies launched at the North Carolina Cancer Hospital, UNC Lineberger’s Stephanie Wheeler, and Donald Rosenstein, will use the grant to connect cancer patients with potential financial support resources in Carteret, Dare, Jackson, Lenoir, and Nash counties.
The study is an extension of an ongoing investigation by UNC Lineberger researchers into the cost that cancer care places on patients through the direct costs associated with treatment, lost income or wages, the psychological burden associated with high-cost care as well as potentially harmful behavioral strategies that patients might use to cope with costs, such as skipping treatment. Collectively, researchers refer to this impact as financial toxicity.
Wheeler reported at the American Society of Clinical Oncology’s Quality Care Symposium last year on the results of a national survey of more than 1,000 women with metastatic breast cancer that was funded by Pfizer and the National Comprehensive Cancer Network.
Nearly a third of these women lacked insurance, and many felt “significant” or “catastrophic” financial effects from cancer. Rosenstein and Wheeler realized that this problem extends well beyond metastatic disease and breast cancer.
The team, led by Wheeler and Rosenstein, mapped the process of applying for financial assistance, and it became clear patients needed a trained professional to help navigate these resources. The need for financial navigation also was identified as a priority by a statewide network of oncology navigators, whose role was to support cancer patients as they transitioned from active care into survivorship.
Informed by work led by researchers at the Fred Hutchinson Cancer Research Center and published in the American Journal of Managed Care, the team tested a financial navigation program for 50 patients at the North Carolina Cancer Hospital. In this pilot program, funded by the UNC Center for Health Innovation, researchers screened patients for financial risk and then had a social work-trained financial navigator work with the patient to assess their financial needs and identify potential resources to help them.
The results of the study have not yet been released, but researchers said their early data show that having a financial navigator eases patients’ anxiety and connects them to resources that help to reduce measurements of financial toxicity.
“The striking thing was that nearly everyone we screened in the cancer clinic showed signs of financial stress or risk,” Rosenstein said.
The new grant is a follow-up to that study to see if financial navigation can be disseminated to rural areas, Rosenstein said. They will be partnering with Carteret Health Care in Carteret County, Harris Regional Hospital in Jackson County, The Outer Banks Hospital in Dare County, UNC Lenoir Health Care in Lenoir County, UNC Cancer Care at Nash in Nash County, and the Patient Advocate Foundation.
