Independent community oncology practices significantly reduce financial toxicity for cancer patients compared to hospital outpatient settings, according to a new study published in the American Journal of Public Health.
The study was led by Lucio Gordan, MD, president and managing physician of Florida Cancer Specialists and Research Institute (FCS), with several coauthors from FCS leadership. Financial toxicity, a term that emerged around 2013 with the rise of immunotherapy, refers to the economic burden of cancer care on patients and their families, impacting their overall wellbeing.
Titled “The Role of Utilizing Community Oncology Care To Decrease Cancer-Related Financial Toxicity,” the study analyzed real-world claims data and revealed significant cost differences due to lower drug markups, reduced facility fees, and more efficient care delivery in independent community settings.
Results showed that patients treated in community oncology clinics incurred a mean monthly cost of care 24% lower than those treated in hospital outpatient settings, averaging $12,548 versus $16,555. When focusing specifically on branded chemotherapy, costs were 39% lower in community oncology clinics, at $6,674 compared to $10,900 in hospital-based clinics.
“These findings reinforce what many of us in community oncology have long observed,” Gordan said in a statement from the Community Oncology Alliance (COA), which represents independent community practices. “Patients benefit not only from compassionate, personalized care close to home, but also from dramatically lower financial strain during one of the most difficult periods of their lives.”
The study highlights how drug markups and facility fees substantially contribute to patients’ total cost of care, with hospital-based oncology departments charging notably higher fees. The design of many health plans, including Medicare, means drug markups directly affect patient out-of-pocket costs. Notably, the popular $2,000 out-of-pocket cap applies only to Medicare Part D and does not cover infused drugs paid for under patients’ medical benefits.
“This new data reaffirms what COA has championed for years—that community oncology is the backbone of cancer care in this country, delivering better value and outcomes for patients,” said Ted Okon, executive director of COA. “As policymakers and stakeholders evaluate solutions to rising cancer costs, it is critical that we do everything we can to support and strengthen the independent community oncology system.”
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