Coverage and Cost-of-Care Links: Addressing Financial Toxicity Among Patients With Hematologic Cancer and Their Caregivers

Jean S. Edward, Laurie E. McLouth, Mary Kay Rayens, Lori P. Eisele, Tani S. Davis, Gerhard Hildebrandt

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


PURPOSEThis study examined the feasibility, acceptability, and preliminary effectiveness of an oncology financial navigation (OFN) intervention, Coverage and Cost-of-Care Links (CC Links), among patients with hematologic cancer and their caregivers who are at increased risk of experiencing financial toxicity (FT).METHODSAll patients who presented to the Division of Hematology and Bone and Marrow Transplant (BMT) at an National Cancer Institute-designated cancer center between April 2021 and January 2022 were screened for FT during inpatient and outpatient visits. Patients who screened positive for FT and met the inclusion criteria were recruited to participate in CC Links that provided financial navigation and assistance via a financial navigator. Caregivers of patients undergoing BMTs were also recruited to participate. Primary outcomes were defined as improvements in FT, distress, and physical and mental quality of life.RESULTSFifty-four patients and 32 caregivers completed the intervention and pre-/postintervention surveys. CC Links resulted in statistically significant decreases in the Comprehensive Score for FT for both patients (|t| = 2.42, P =.019) and caregivers (|t| = 2.43, P =.021) and total FT (|t| = 2.13, P =.041) and material conditions scores (|t| = 2.25, P =.031) for caregivers only. Only 27% of eligible patients participated in the study, whereas 100% of eligible caregivers participated. The majority of participants rated the intervention highly for acceptability (89%) and appropriateness (88%). An average of $2,500 (USD) in financial benefits was secured per participant via CC Links.CONCLUSIONCC Links was effective in decreasing FT among patients with hematologic cancer and their caregivers while demonstrating high acceptability and appropriateness ratings.

Original languageEnglish
Pages (from-to)E696-E705
JournalJCO Oncology Practice
Issue number5
StatePublished - May 1 2023

Bibliographical note

Funding Information:
Research Funding: Takeda, Jazz Pharmaceuticals, Pharmacyclics, Incyte, AstraZeneca

Funding Information:
Supported by the National Cancer Institute's Administrative supplements for P30 Cancer Center Support Grants to Address Financial Hardship During Cancer Treatment (3P30CA177558-08S4); the University of Kentucky Markey Cancer Center (P30CA177558); the Patient Oriented and Population Science Shared Resource Facilities, Research Communications Office, and Joan Scales, LCSW and the Psych-Oncology Program at the University of Kentucky Markey Cancer Center; and UK HealthCare's Patient Financial Services. L.E.M. was supported by KL2TR001996.

Publisher Copyright:
© American Society of Clinical Oncology.

ASJC Scopus subject areas

  • Oncology
  • Health Policy
  • Oncology(nursing)


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