Cancer treatment is often associated with intense physical and emotional challenges, but one of the most insidious and less frequently discussed burdens patients face is financial toxicity. This term refers to the financial distress or hardship that patients endure due to the high cost of cancer care. Recognizing the severity of this issue, the Levine Cancer Institute in Charlotte, North Carolina, established a financial toxicity tumor board (FTTB) in 2019. This innovative intervention mimics the structure of a traditional tumor board—where medical experts meet to discuss patient care—but with a primary focus on addressing financial distress among cancer patients. Recent research published in the Journal of the National Comprehensive Cancer Network highlights the remarkable success of this initiative in reducing financial toxicity and improving patient outcomes.
The FTTB operates by categorizing patient cases into three distinct groups, reflecting the nature and urgency of each case. The first category, "immediate assistance required," encompasses urgent situations such as newly diagnosed patients who face sudden loss of income or health insurance. These cases demand prompt resolution during the tumor board meetings to prevent financial crisis from compounding medical vulnerabilities. The second category, "system-level issues," includes challenges stemming from the intricate and sometimes frustrating healthcare system—such as denials of treatment coverage from payers and insurers. The third category, "policy/legislative issues," involves cases that require collaboration with external stakeholders and advocacy groups to tackle broader systemic barriers, such as Medicaid regulations that may hinder access to necessary medical equipment or services. By systematically organizing cases into these categories, the FTTB ensures that each problem is addressed with an appropriate and targeted approach, enabling more effective, timely interventions.
Since adopting its current format in 2023, the FTTB has reviewed 50 patient cases, with an overwhelming majority classified as requiring immediate assistance. Impressively, 94% of these cases have been completely resolved through the FTTB’s efforts, underscoring the potency of this focused intervention. One of the most impactful components of the board is the integration of a pharmacy-based patient assistance program (PAP), which targets drug approvals and addresses financial challenges associated with obtaining necessary medications. This program has had a tremendous reach: over the past five years, it has provided copay assistance to more than 9,300 patients, resulting in over $10 million in financial relief. Meanwhile, nearly 16,500 patients have received free drug assistance, translating to a staggering $392 million in savings. These figures not only demonstrate the scale of the financial barriers in cancer care but also highlight the potential for structured programs to mitigate these burdens at a systemic level.
What stands out about the FTTB initiative is that it addresses financial toxicity not as an isolated issue but as a complex, multifaceted aspect of cancer care that intersects with healthcare policy, insurance systems, and patient advocacy. This holistic and proactive approach has garnered praise and suggests the model could serve as a blueprint for other healthcare institutions. The idea that a tumor board could expand its traditional clinical focus to encompass financial challenges illustrates an evolving understanding of patient-centered care. Not to mention, the success of this program might encourage further collaboration between healthcare providers, insurers, and lawmakers to improve access to care and reduce financial hardships. Interestingly, while tumor boards traditionally concentrate on medical treatment options and prognoses, the financial toxicity tumor board broadens the scope of multidisciplinary care to include economic well-being—a critical determinant of health outcomes.
The financial toxicity tumor board's success, supported by the Leon Levine Foundation and detailed in a study led by Knight et al., is a beacon of hope for cancer patients navigating the daunting landscape of treatment costs. It reflects a growing awareness within the medical community that addressing financial challenges is essential to comprehensive cancer care. As healthcare costs continue to rise, especially in oncology, systemic innovations like the FTTB may well become standard practice, helping to buffer patients from the economic fallout of their disease. Ultimately, this initiative is a reminder that cancer care is not just about combating the disease but also about supporting the whole person, including their financial health—because surviving cancer should never come at the cost of financial ruin.
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