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Centre for Health Economics and Policy Analysis


The financial toll on patients and families of a cancer diagnosis

06 Jan 2020

The results of a national study of the financial impact that cancer treatment has on Canadian patients and families was analyzed by CHEPA member Dr. Christopher Longo, Associate Professor of Health Policy and Management at McMaster’s Degroote School of Business, at a seminar on Wednesday, Jan. 15.

The impact of a cancer diagnosis goes beyond the clinical and emotional complexities to include impacts on patient and family financial security, with those in low income populations or who lack private health insurance more severely affected.  Longo’s seminar, entitled A National study evaluating patient and family financial burden associated with cancer treatment in Canada” will describe the results of research that evaluated the financial burden experienced by 901 patients from BC (131) Alberta (113), Manitoba (134), Ontario (472), and “rest of Canada” (51), including 344 breast, 183 colorectal, 158 lung and 216 prostate patients, with an average treatment duration of 318 days.

Study Methods

Patients with breast, colorectal, lung and prostate cancers across Canada completed the Patient Self-Administered Financial Effects (P-SAFE v7.2.1) questionnaire.  This tool captures patient out-of-pocket costs (OOPC), lost income, travel costs and foregone services, and has been applied in numerous settings nationally and internationally.  Data was inputted and analyzed at McMaster University.


901 patients from BC (131) Alberta (113), Manitoba (134), Ontario (472), and “rest of Canada” (51) were evaluated, including 344 breast, 183 colorectal, 158 lung and 216 prostate patients, with average treatment duration of 318d. Monthly OOPC for medically related services were $518. Notable cost categories included: devices ($129), pharmaceuticals ($70), CAM ($55), and vitamin/supplements ($51).  National Parking/Fares were $84, and travel $179.  Comparison of total monthly costs from Ontario in 2001-2003 (earlier P-SAFE version) to current shows an increase from $213 to $461.  Patients with private health insurance coverage decreased from 92% to 70.3%.  National income loss averaged $1942/month for patients and caregivers combined.   Forty-one percent of Canadian patients’ indicated spending changes as a result of cancer related costs (54% if <65yrs). Patients <65yrs had significantly higher costs (p=0.0011).


These results suggest a 200%+ increase in financial costs of a cancer diagnosis since 2003 in Ontario, now nationally averaging $2723 per month. Some of this increase can be explained by fewer patients having private health insurance, and by reduced home based care support. Financial decisions to forego care appear to be high for a largely publicly funded healthcare system.

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