Associate Professor Christopher Steer

A six point plan to end financial toxicity for cancer patients has been launched by Private Cancer Physicians of Australia (PCPA) and Rare Cancers Australia.

With figures showing that cancer patients may face out of pocket costs of $3675 per year for treatment and medications, the PCPA has released an election manifesto that calls for a measures such as a cancer patient financial safety net and care navigators for the private system backed up by an online ‘financial concierge’ hub.

Under its ‘Cancer Care, No Gaps’, proposals, the PCPA says “a cancer diagnosis should not force any Australian to live under the poverty line.”

“To tell a patient they have cancer, is hard,” PCPA President Associate Professor Christopher Steer said in a statement accompanying the launch of the manifesto.

“To watch that patient, and their family, then struggle with the worry and stress over the financial impact of such a diagnosis, is something we can no longer tolerate, without trying to do as much as we can to lessen that burden.”

“As cancer physicians providing high quality, personalised, patient-centred care, we work very hard to control the out-of-pocket expenses that are within our control,” says A/Prof Steer, a medical oncologist at Border Medical Oncology at the Albury Wodonga Regional Cancer Centre in NSW.

“As patient advocacy leaders, we see first-hand the often-extreme choices some patients feel they must make. Sell the house or have treatment? Retain childcare services or have treatment? Keep working or take the much needed time off to recover? Cancer treatment should never come with a question mark over whether the patient can afford it or not.”

The proposal notes that in some cases, it is estimated that cancer patients may be paying up to $22,000 from their own pocket during their cancer treatment. Median out-of-pocket costs were reportedly highest for therapeutic procedures ($670), professional attendances ($414) and medications ($288).

According to the PCPA, cancer patients currently must spend more than $2133 on PBS medicines and more than $1542 on Medicare services in a calendar year before they can access patient safety net schemes.

They therefore propose that the federal government creates a special MBS and PBS “Cancer Patient Safety Net” category that is triggered immediately a cancer diagnosis is made. This would ensure the cost of cancer care is not influenced by the month of diagnosis and would eliminate the discrimination patients face if diagnosed later in the year, the proposal explains, because  the current patient safety net resets every January.

At an estimated cost of $76 million per year based on nearly half (or 70,000) Australians diagnosed with cancer each year, needing active cancer treatment this policy initiative “is implementable, scalable, cost effective,” says A/Prof Steer.

Other proposals include:

• Provision of experienced patient facilitators to help all cancer patients and their families navigate what can be an overly complex private health system; (Estimated cost: $10 million per annum).
• Permanently subsidising (via Telehealth) specialist phone consults.
• Creation of a technology-driven ‘financial concierge’ system to ensure all cancer treatment bills (regardless of what, and where, that provider is) can be seen and centred in one place, to reduce the ‘bill shock’. (Estimated cost: $5 million).
• Enabling regional and rural cancer patients to access bulk billing by reinstating the 50% MBS loading for video consultations for regional and rural patients.
• A pilot program to financially enable people living with cancer in rural and regional Australia to access investigator-led clinical trials away from home.

“All of these carefully thought-out, cost-effective initiatives have been developed by some of the nation’s most experienced and respected oncologists, supported by Australia’s leading patient advocacy groups,” the proposal states.

“We are all on the frontline of cancer care every day and always have the patient’s best interests at heart. We commit this election manifesto to the Government for consideration and we look forward to continuing to work with it to ensure the best outcomes for all Australian cancer patients and their families.”