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Financial Toxicity

  • 1.  Financial Toxicity

    Posted 05-14-2019 18:20
    ​I am looking for ways to approach patients to address financial toxicity/financial stress. Looking through the navigator group there was a posting of Diane McElwain's in 2017 connecting to ACCC-looked promising-it was a Web based 'boot camp'-unfortunately my organization is not a member. I also found a posting from the Metro Detroit group that posted a webinar in 2018.
    Anyone have a good tool they would share?
    Anyone looking at this issues currently?

    Patty Kormanik NP
    UCSD North County Cancer Services
    Encinitas CA

  • 2.  RE: Financial Toxicity

    Posted 05-15-2019 06:30
    Hi Patty!
    I am very interested in this topic and have been looking at the evidence. I am working on my DNP and this will likely be the focus of my project. I saw the boot camp too and plan on completing it this summer as my institution is a member. 
    Triage Cancer and Cancer and Careers are two great sites with more information on finanacial toxicity. Triage Cancer is holding a five hour intensive on insurance and finances as part of the ONA Navigation Summit next month in Philadelphia, which might be of interest to you. I am looking at my schedule to see if I can get there. They have additional sessions in other locations around the country. 

    Would love to discuss this more with you or anyone else interested in financial toxicity. I hear  daily from my patients about the financial burdens they face!

    Sent from Workspace ONE Boxer

  • 3.  RE: Financial Toxicity

    Posted 05-15-2019 08:15
    ​Yes! Always looking for tools and resources.  This is an ongoing issue and continues to  get more complicated.  Following to learn suggestions from the group.

    D Lynn Hayes
    Oncology Nurse Navigator
    Farmersburg IN

  • 4.  RE: Financial Toxicity

    Posted 05-15-2019 09:01
    ​Hello Ms. Patty,

    While researching for the topic of Financial Toxicity, we came across the COmprehensive Score for financial Toxicity (COST) instrument. Although the aim of our publication, see below, was to address the concept of financial toxicity and some the resources available, this may give you a better guide to start your research.

    Hope this helps,

    Oncology Nursing Society | CJON
    Ons remove preview
    Oncology Nursing Society | CJON
    Engagement with social workers, chaplains, clinical psychologists/psycho-oncologists, and community-based organizations can support patients as they navigate survivorship. Patients may also seek connection through online forums, including social media and online support groups that are specific to recipients of CAR T-cell therapy (American Society of Clinical Oncology, 2017).
    View this on Ons >

    Joaquin Buitrago, MS, RN, OCN
    Nurse Educator
    MD Anderson Cancer Center

  • 5.  RE: Financial Toxicity

    Posted 05-20-2019 10:12
    Edited by Erin Dickman 05-20-2019 10:14
    Another resource that could be of help is the ONS created Oncology Nurse Navigator Toolkit: Helping Patients Navigate Financial issues. You can find it here:

    Erin Dickman MS, RN, OCN
    Oncology Clinical Specialist
    Oncology Nursing Society
    Columbus, OH

  • 6.  RE: Financial Toxicity

    Posted 05-20-2019 16:39
    Hi Erin-thanks for the link-had heard about the ONS toolkit but couldn't find it. ASCO also has a booklet Managing the cost of Cancer Care-practical guidance for patients and families. Both have good basic information. Patty​

    Patty Kormanik NP
    UCSD North County Cancer Services
    Encinitas CA

  • 7.  RE: Financial Toxicity

    Posted 05-21-2019 12:16
    ​I just attended a conference from Triage Cancer (; really informative with great resources on this topic.
    They provide a NeedyMeds Drug Discount Card which helps private insurance patients lower their drug costs.

    Additionally, the magazine "Conquer: The Patient Voice" from AONN (Academy of Oncology Nurse and Patient Navigators) just came out with their 3rd Annual Patient Guide to Cancer Support Services 2019 edition which lists all the drug companies discount programs.

    In an ideal world, we would all have Financial Navigation at our facilities. We have just gotten the OK to do a 3 month trial utilizing one of the hospital's financial counselors solely dedicated to the Onc department. We think it can make a huge impact for our patients.

    Maggie Oswald, ANP-BC
    Oncology Survivorship NP
    Northwestern Lake Forest Hospital
    Lake Forest, IL

    Maggie Oswald
    Evanston IL

  • 8.  RE: Financial Toxicity

    Posted 05-21-2019 12:55
    ​Hi Maggie!
    Did you go to the Insurance and Finance Intensive? I am trying to get to the June presentation in Philadelphia, but it may not work with my class schedule (I'm a DNP student). It looked really good.
    I agree that 1) all institutions need a financial navigator that is a patient advocate with appropriate education (LISW, RN, etc), 2) providers and patients need education on this issue to feel comfortable starting the conversation, and 3) there needs to be some sort of universal screening at pivotal points in the treatment process to identify patients at-risk and get them to resources early.
    I am interested in learning more about the process you went through to get approval for a dedicated financial counselor for your oncology patients!
    Thanks, Rupa

    Rupa Ghosh-Berkebile, MS, APRN-CNP, AOCNP
    Nurse Practitioner--Cancer Supportive Care
    James Cancer Hospital and Solove Research Institute
    Columbus, OH

  • 9.  RE: Financial Toxicity

    Posted 05-21-2019 14:03

    My take on this presentation is that it is impressive as an organization but as a NP, I think you could probably get a decent understanding from their website alone. I think patients who attend get the biggest benefit and I am glad I went, but it was like 25 mins from my house.

    In terms of a financial navigator, my breast cancer navigation colleagues get the credit for moving this forward. They have been doing their jobs for like 12 yrs and have been advocating for this role as they have been front and center with dealing with patient's financial concerns. The squeaky wheel definitely gets heard.

    Maggie Oswald, ANP-BC

    Oncology Survivorship Nurse Practitioner

    Lake Forest Hospital


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  • 10.  RE: Financial Toxicity

    Posted 05-21-2019 18:00
    We are currently running this trial:

    The one investigator worked with Dr. Zafar

    Dr Chino is graduating from her radiation oncology residency this year - her own story is pretty wrenching. I am glad there is getting to be more interest in this topic.

    John Hillson RN
    Hillsborough NC