Clinicians Believe That at Least Half of Their Patients Have Difficulty Paying for Treatment (NCCN)

Clinicians are in tune with the difficulties cost of care presents for their patients. According to a new NCCN Trends™ Survey, most clinicians believe that at least half of their patients have difficulty paying for treatment. Indeed, 52 percent of the 241 surveyed clinicians responded that the proportion of their patients having trouble paying for treatment was at least half. Further, clinicians indicated that when selecting among intervention options that are clinically equal, they will consider the patient’s cost burden. When asked to rate the importance of different cost domains when cost must be considered, 74 percent of clinician respondents regarded the “patient’s out-of-pocket expenses” as being very important. The practice or institution’s financial situation, overall cost to society, and cost to the payer were considered to be very important by 39 percent, 26 percent, and 18 percent of clinician respondents, respectively.

Attendees of the NCCN 15th Annual Conference, held in Hollywood, Florida last month, responded to an NCCN Trends™ Survey focusing on cost and reimbursement. The survey included questions regarding difficulty in paying for treatment, cost of care, satisfaction with Patient Assistance Programs (PAPs) and prior authorization. Respondents, 79 percent of whom identified themselves as practicing clinicians, including physicians (40 percent), advanced practitioners or nurses in oncology (32 percent), and pharmacists specializing in oncology (7 percent), answered questions at an NCCN Trends™ Survey kiosk located in the NCCN Reimbursement Resource Room.

The NCCN Reimbursement Resource Room and the NCCN Virtual Reimbursement Resource Room serve as a resource for clinicians interested in learning about reimbursement help and services available, including PAPs. PAPs are generally industry-sponsored and provide free medications to people who cannot afford their medicine. The majority of the clinicians responding to the NCCN Trends™ survey utilize industry-sponsored PAPs; 71 percent responded that they frequently or sometimes use these programs. Six percent of respondents were unaware of PAPs. Moreover, clinicians responded that they are overall satisfied with the ease of enrolling in PAPs and the ease of acquiring medications through them; the rates of at least moderate satisfaction in these domains were 87 percent and 84 percent, respectively. Indeed, responding clinicians indicated that they were at least moderately overall satisfied with PAPs 87 percent of the time. 

Clinician satisfaction with the ease of obtaining prior authorization for diagnostic testing is a different story. Obtaining prior authorization for diagnostic tests including Multiple-Gated Acquisition (MUGA) Scan, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), and Positron Emission Tomography/Computed Tomography (PET/CT) is difficult for clinicians according to the NCCN Trends™ Survey respondents. Indeed, 67 percent of clinicians responded that it is “very difficult” or “somewhat difficult” to obtain prior authorization for PET/CT, and 66 and 34 percent report it to be somewhat or very difficult to obtain prior authorization for PET and MRI, respectively.

NCCN Trends™ Survey

In general, what proportion of your patients has significant difficulty paying for treatment (including uninsured, underinsured, out-of-pocket costs for those with insurance, etc.)?

The results, depicted in the chart below, were filtered to include practicing clinicians (n = 241) only.


When you are in a situation where costs of an intervention must be considered, how much importance do you assign to the following domains in your overall decision to select an intervention? Assume available options are clinically equal.

The results, depicted in the chart below, were filtered to include practicing clinicians (n = 241) only.


Taking your combined experience with all payers into account, how difficult has it been to obtain prior authorization for the following types of diagnostics/imaging in general?

The results, depicted in the chart below, were filtered to include practicing clinicians (n = 241) only.

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