How much does low-value care cost cancer patients?

By Judith Garber | November 19, 2021

We’ve written about the ways in which unnecessary follow-up care can lead to physical, mental, and social harms. But financial harms — particularly for cancer patients, who often need very expensive treatments — are incredibly impactful for patients as well. Many cancer patients experience detrimental effects of financial strain from treatment, known as “financial toxicity“; as many as one-third of cancer survivors have taken on debt to pay for treatment.

Much of this financial toxicity is due to the high cost of new treatments and gaps in insurance coverage. But low-value care, services that have little or no clinical benefit, also plays a role.

According to a recent study from researchers at the West Virginia University School of Pharmacy, low-value care is common among patients with certain types of cancer, and contributes to out-of-pocket spending. They examined how often older adults diagnosed with breast, prostate, colorectal cancers, and Non-Hodgkin’s Lymphoma received subsequent low-value procedures within a year. They found that 29% of older adults with these types of cancer received at least one low-value service, most commonly carotid artery screening or MRI for low back pain.

Even though these patients were covered by Medicare, patients that got low-value procedures had thousands more in out-of-pocket costs. The average out-of-pocket cost for cancer patients who received at least one low-value service was $8,726, compared to $6,802 for patients who did not get any low-value care.

For cancer patients who are struggling with both their health and finances, it is imperative that doctors and health system minimize preventable harm of low-value care. They would be wise to follow Dr. Bernard Lown’s advice: “Do as much as possible for the patient and as little as possible to the patient.”

To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.