Alleviating Patient Burden

The cost of care for breast cancer patients continues to create barriers in access to screening and treatments through insurance design. High cost-sharing is a barrier to care, as it prevents patients from accessing the screening and treatments prescribed by their providers or forces providers to make decisions based on outdated health plan benefits rather than what is best for the patient. Cancer treatments can be very expensive and require long-term monitoring and follow-up care, potentially exposing patients to significant financial hardship. More and more stakeholders in the cancer community are recognizing the financial toxicity associated with adhering to treatment as prescribed, which can not only expose patients to financial ruin but also can negatively affect their health if they are forced to delay or stop treatment or make suboptimal treatment decisions due to cost. Addressing financial toxicity and how it impacts patients’ treatments and overall health is key to saving lives from breast cancer. Komen advocates for policies to reduce insurance barriers that shift costs to patients, preclude provider decision making and place unnecessary burdens on accessing needed care.

Alleviating Patient Burden Priorities

  • Reduce or eliminate out-of-pocket costs for all medically necessary screening and diagnostic imaging.
  • Protect patient preference, enhance coverage, reduce cost and address barriers to breast cancer treatments, including those that would require oral parity, preclude specialty tiers, prevent step therapy protocols, prevent usage of co-pay accumulators or limit patients’ out-of-pocket costs.
  • Expand access to genetic and genomic testing.
  • Support policies that provide access to a patient navigator and/or navigation tools to assist cancer patients throughout the continuum of care.