Original Contribution Understanding Patients ’ Attitudes Toward Communication About the Cost of Cancer Care

Purpose: Recent publications have promoted physician-pa-tient communication on cost as a means of decreasing overall spending and minimizing patients ’ financial burden in oncology. No study has assessed patients ’ perspectives on cost commu-nication in oncology. We sought to describe oncology patients’ attitudes toward cost communication, explore potential predic-tors for patients ’ communication preferences, and assess how patients with cancer consider cost when making management decisions. Methods: A 31-item questionnaire was developed to measure oncology patients ’ communication preferences regarding the cost of cancer care, focusing on out-of-pocket costs. Items were adapted from other instruments when possible. After piloting, patients were recruited from an academic ambulatory oncology practice. Basic descriptive statistics were applied. Results: Of the 771 patients approached, 256 responded (response rate, 33%). Most (68%) preferred to know about out-of-pocket costs before treatment. A majority (59%) wanted their physician to discuss these costs with them. Although 76 % re-ported feeling comfortable discussing cost with their physician, 74 % were amenable to discussing cost with someone other than their physician. Most patients did not consider out-of-pocket costs (57%) or the health care costs of the country (61%) in their decision making, nor did they believe their physician should (55%). Patients receiving active chemotherapy were less likely to want to discuss out-of-pocket costs with their physician (P .035). Conclusion: Patients ’ comfort with and desire to discuss can-cer costs exceed that of oncologists, suggesting a need to ed-ucate oncologists on this important topic. A patient’s desire to understand treatment-associated cost does not equate with a desire for cost to influence medical decision making