Characterizing and Addressing the Financial, Time, and Administrative Burdens of Cancer and its Care.

Abstract

Opinion statement: The success of cancer care delivery must be evaluated not only by efficacy outcomes such as overall survival, but also by the experiences of patients and their informal caregivers throughout the course of care. Financial, time, and administrative burdens constitute a triad of non-physical "toxicities'' that greatly affect patient and caregiver experiences-and outcomes- and should be routinely considered and addressed in oncology practice. While all these burdens have been ever-prevalent, the increasing complexity of cancer care has made these issues more relevant over time. Financial and time burdens started receiving mainstream attention in the oncology community circa 2010 and 2020 respectively. Administrative burdens are currently less well defined but are increasingly recognized and consequential. Each component of the triad does not exist in isolation-financial, time, and administrative burdens can overlap with, interact with, and compound each other. Attempting to address one may worsen another-for example, transferring a medicine prescription and driving to another pharmacy 20 miles away where the co-pay is $50 lower may reduce direct medication out-of-pocket costs, but increase both time and administrative burden. The current piece summarizes the current status of the field with the hope it galvanizes the oncology community to understand and manage these burdens, so patients and caregivers can live their fullest lives.