Many cancer docs don't discuss costs of pricey gene tests

Fighting cancer can be a long, hard battle, not to mention expensive. Now, new research shows that a quarter of oncologists don't discuss the cost of expensive tests with their patients.

Genomic tests on cancer cells can help determine which types of treatment might work, and which ones might not. However, such testing can be expensive, and not all tests and related treatments are covered by health insurance, the researchers noted.

Informed decisions

Costs of cancer care are rising, and there are increasing concerns about high patient out-of-pocket costs for cancer treatment.

Discussions with their oncologists can help patients make informed decisions about treatment and prepare for potentially high costs. So, the study authors wanted to find out how often oncologists discuss costs of genomic testing and treatment with patients.

They analysed data from 1 220 US oncologists who took part in a national survey on precision medicine in cancer care.

Half of them said they often discussed the likely costs of testing and related treatments with patients; 26.3% said they sometimes discussed costs; and 23.7% said they never or rarely discussed costs.

Further investigation showed that oncologists trained in genomic testing or who worked in practices with electronic medical record alerts for genomic tests were about two times more likely to discuss costs with patients sometimes or often.

Higher-quality cancer care

Other factors associated with being more likely to discuss costs with patients included: treating patients with solid tumours; using next-generation sequencing gene panel tests; having higher patient volume; and working in practices with higher percentages of patients with Medicaid, private insurance or no insurance.

"Initiating a discussion about the expected out-of-pocket costs of genomic testing and related treatment is a necessary first step, but is not sufficient to ensure that patients and their families can make fully informed decisions about treatment options," said lead researcher Robin Yabroff, from the American Cancer Society.

"In the context of rising costs of cancer care, interventions targeting modifiable physician and practice factors may help increase the frequency of physician-patient cost discussions, contributing to more informed patient decisions and higher-quality cancer care," the researchers said in a society news release.

The study was published in the Journal of the National Cancer Institute.

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