Screen every cancer patient for financial toxicity as a vital sign, with navigation
Cancer costs push patients into debt and make them skip treatment. Asking about money at every visit, and having someone to help, catches this before it does harm.
Financial toxicity affects a large share of patients even in insured and universal systems and is associated with non-adherence and worse survival. Validated instruments (COST-FACIT) exist, and financial navigation programmes have shown reductions in patient debt and distress in US trials. The proposal is to embed a short financial toxicity screen in routine patient-reported outcome collection at each cycle, with an automatic referral to a financial navigator and a data feed to payers documenting the burden by drug and regimen.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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