The financial impact of breast cancer | ISSUE OF CONCERN

If someone had said to me ‘When you get cancer it costs money’, it wouldn’t have occurred to me what that meant until now. – Farrah

A diagnosis of breast cancer is a major trauma in your life. Fears and anxieties around treatment and health, both immediate and in the future (‘Will I survive this?’) are common and understandable. However, there is another element of trauma that is not often considered – the financial trauma of breast cancer.

Over our nearly 20 years, we have often heard from our members about the impact a breast cancer diagnosis and treatment has on their financial situation. Unlike some other cancers, active treatment for early breast cancer (surgery, chemotherapy and/or radiotherapy) can continue for 12 months and daily hormone therapy treatment may continue for up to 10 years beyond that. Some women find that the financial impact of breast cancer over such a long time puts a huge strain on both their budget and their relationships. Some women are pushed into poverty, forced to rely on government benefits, support from charities or emergency help from family, friends and community to get by.

To learn more about how breast cancer impacts women’s finances BCNA commissioned Deloitte Access Economics to conduct an online survey of our membership. Almost 2,000 women completed the survey, indicating how important this issue is to many of you. BCNA also interviewed 16 women extensively, to better understand the financial impacts of breast cancer on them.

The survey and interviews found that many women with breast cancer worry about their finances as much as they worry about their health. Some of the factors that contribute to financial worries include:

  • using private health insurance and having to pay ‘gap’ fees
  • having a breast reconstruction
  • living in a rural or regional area
  • paying for tests not covered by Medicare, such as MRI scans and Oncotype DX gene testing
  • work-related issues such as needing to reduce work hours or stop working altogether during treatment.

Our survey found that most women pay some out-of-pocket costs, with only 12 per cent reporting no out-of-pocket costs for their breast cancer treatment and care. The out-of-pocket costs for the remaining 88 percent of women typically ranged between $1,500 and $17,200, with women usually paying around $4,800. Some women paid significantly more, into the tens of thousands of dollars. Having breast reconstruction in the private health system is usually associated with these very high costs.

We used our redraw facility from our mortgage because we had to pay $24,000 for the plastic surgeon up front. We had to pay $6,000 for the anaesthetist up front. We did get some of it back, but I think all up we’re probably $13,000 out of pocket just on the surgery. – Susan

Women with private health insurance pay over 10 times as much as women without private health insurance on their direct medical costs, typically around $3,700 for women with private health cover compared to around $350 for women without private health cover. The amount spent on non-medical items, such as wigs, transport and post-mastectomy bras, was very similar for women who have private health cover and women who do not, at around $3,300 for both groups. This tells us that the big difference in costs comes down to treatment in the private hospital system and paying large ‘gap’ payments for medical treatment.

Having radiotherapy in the private system is also associated with high out-of-pocket costs. Radiotherapy is not covered by private health funds as it is an outpatient procedure. Some women may not be aware that they have the option of having some of their treatment – such as surgery and chemotherapy – as a private patient in a private hospital and other treatments – such as radiotherapy – as a public patient. This can help keep costs down.

The survey looked at costs for the first two years after diagnosis, but we know that many women will have costs that continue for many years. These may include paying for ongoing lymphoedema treatment, hormone therapy drugs such as tamoxifen, letrozole and anastrozole, and counselling.

To read the full report, visit our website.

BCNA will continue to advocate to reduce the financial burden for Australians affected by breast cancer.

Farrah

Farrah

Issue 80
Spring 2017