Breast cancer patients face an especially high cost of health care compared with people who have other types of cancer, according to authors of a paper published March 6, 2019 in Cancer, a peer-reviewed medical journal of the American Cancer Society. Those costs rise even higher for those who have lymphedema, a common side effect of treatment for breast cancer that causes painful swelling in the arms, legs, or torso.
There are more than 3 million breast cancer survivors in the US. Almost 35% of them, about 1 out of 3, have lymphedema, and the study authors estimate they face $14,877 in out-of-pocket costs in their first 2 years of diagnosis. Even up to 10 years after diagnosis, their out-of-pocket health care costs are more than double the costs for those without lymphedema.
Many public health insurance plans do not cover some home treatments for lymphedema -- for example, compression bandages, sleeves, or stockings. So far, recommendations for ways to reduce the financial burden have mostly come from health care providers and focused on how patients are billed for services. This study asked the patients themselves to recommend ways health care systems, businesses, and nonprofit organizations could help them manage costs that come from health care bills as well as other expenses that affect work and home responsibilities.
The researchers interviewed 40 women with breast cancer, 24 of whom had lymphedema. They organized their responses into 9 recommendations:
The number of breast cancer survivors is expected to increase from 3.1 million to 4.5 million in the next 10 years. The researchers write, “Without changes, out-of-pocket costs will continue to be a challenge for the growing number of breast cancer survivors in the United States.”
California, Louisiana, Maryland, North Carolina and Virginia have passed laws that expand lymphedema treatment coverage under existing insurance. Congress has considered but not yet passed legislation that would do the same across the nation.
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Patient Recommendations for Reducing Long-Lasting Economic Burden After Breast Cancer. Published March 6, 2019 in Cancer. First author Lorraine T. Dean ScD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.