New standard encourages doctors to disclose out-of-pocket costs

For many years, BCNA has heard from Australians diagnosed with breast cancer who have been hit with large unexpected bills for their breast cancer treatment; an experience known as bill shock. These bills often add to the distress of their breast cancer diagnosis, coming at a time when individuals and families are already coping with the fear, uncertainty and stress of a cancer diagnosis.

In an effort to increase transparency around out-of-pocket costs of treatment and encourage patients and doctors to discuss fees before treatment begins, BCNA collaborated with Cancer Council Australia, CanTeen and Prostate Cancer Foundation of Australia to develop a Standard for Informed Financial Consent.

The standard aims to ensure that people diagnosed with cancer are given information by their treating team about the expected out-of-pocket costs for their cancer treatment and care. We hope this will help people to understand their potential out-of-pocket costs so that they can include these in their budget or shop around for another clinician who might offer lower fees. This will help to reduce bill shock.

In 2017, BCNA surveyed over 2,000 people on the out-of-pocket cost associated with their treatment. Our research found a wide range in out-of-pocket costs. While 12 per cent of those surveyed reported having no out-of-pocket costs, 25 per cent reported out-of-pocket costs of over $17,200.[1] People having their treatment in the private health system were found to have higher out-of-pocket costs than those in the public health system, with a quarter of survey respondents with private health insurance reporting out-of-pocket costs of more than $21,000.

BCNA believes it is vital that health professionals have upfront conversations with people diagnosed with cancer about the direct and indirect costs of their treatment and care. While it is not compulsory for doctors to follow the standard, we hope they will use it to guide conversations with their patients. The Standard sets out the types of expenses patients should expect their doctors to tell them about, such as the cost of surgery, including anaesthetist fees and other associated fees, costs for diagnostic tests, and costs of supportive care services.

The standard also notes that doctors should have conversations about some of the more indirect financial implications of various treatment options, such as lost income due to time off work or reducing working hours.

To further support people affected by cancer and their families to understand the financial costs of cancer, Cancer Council has developed a new fact sheet, The financial cost of healthcare: information for people with cancer and for those caring for someone with cancer. A number of BCNA Consumer Representatives helped with the development of this information, and we thank them for their input and feedback.

More information about the financial cost of breast cancer, including financial support and assistance that may be available, and financial tips to help you, is available on BCNA’s My Journey online tool.

[1] BCNA. ‘The Financial Impact of Breast Cancer’,

Issue 87
Spring 2020