8 Min. Read
For many people a breast cancer diagnosis also brings financial burdens.
No one is prepared for a breast cancer diagnosis. Among the many things that can be unexpected and hard to manage is how much medical treatment and care will cost.
People are living longer, fuller lives after a cancer diagnosis than they have in the past. The reason for this is that diagnosis and treatment options have improved. But better options, which include prescription medicine, also cost more money.
If you are living with breast cancer or caring for someone diagnosed with the disease, your ability to manage the costs of treatment and care will depend on many things, such as:
In addition to the medical costs of breast cancer treatment, there may be costs related to traveling to and from treatment, taking time off from work, treating some side effects (like scalp cooling or wigs for hair loss, for example), and child care.
Of all cancer types, breast cancer has the highest treatment costs, followed by prostate cancer, colorectal cancer, and lung cancer. These costs can often be unexpected for people who’ve been diagnosed and for their loved ones.
A 2022 study revealed that between 2009 and 2016, the average out-of-pocket (OOP) cost of breast cancer treatment increased 29%, from about $110,000 to nearly $150,000 around the first year of diagnosis.
People living with metastatic breast cancer (MBC) can sometimes have costs that are even higher. This is because people living with MBC are living longer than they have in the past. They also have periods of time on and off treatments. Learn more on our Financial matters, health insurance, and work with metastatic breast cancer pages.
Treatment for breast cancer affects all aspects of life. Research has shown that the total cost of treatment can range from $100,000 to $300,000. This session helps you navigate the financial burden of cancer treatment, including out of pocket healthcare costs, insurance, disability, and your rights in the workplace.
Here are some common expenses for people diagnosed with cancer:
Treating lymphedema, a condition that can happen after certain breast cancer treatments, can also add to extra costs.
These costs can lead to financial distress, or financial toxicity.
Financial toxicity is a term used to describe problems patients may have due to the cost of medical care. Many studies show that people with cancer are more likely to have financial toxicity than people who don’t have cancer. Financial toxicity can lead to:
If you are in treatment or living with breast cancer, and you are worried about the costs involved, you are not alone. Due to many things, such as the high cost of treatment, about half of people in the U.S. living with cancer face financial toxicity.
Read more about the financial toxicity of breast cancer, and 10 tips to manage financial toxicity.
Anyone living with an illness, including cancer, can experience time toxicity. That means they spend a lot of time managing care, going to doctor visits, and treating side effects, among other things. Time spent managing an illness impacts time spent at home or doing other things. Caregivers can experience time toxicity, too.
People living with MBC may also have to contend with time toxicity.
Some people diagnosed with breast cancer are more likely to deal with financial toxicity than others.
Health disparities are differences or gaps in health and health care based on things like race, ethnicity, and income. Cancer-related financial toxicity is more likely to affect:
Breast cancer can be expensive
The Living Beyond Breast Cancer Fund provides one-time grants to help ease the financial burden of breast cancer. These grants are distributed to help people in active treatment pay vital expenses such as rent, utility bills, car payments, and car insurance.
While the cost of treatment can be a challenge for many people, there are resources available to help. If you are concerned about paying for treatment and other costs, you are not alone.
Talk with your healthcare team about potential costs that could be passed on to you. Learning about treatment costs as early as possible can help you avoid surprises and help you plan. Resources include:
Ask your doctor, nurse navigator, or hospital social worker about financial navigation and other resources that may be available to you.
Many cancer centers have financial navigators whose job is to help people understand coverage and OOP costs. These navigators may also help people apply for programs and help with resources to address OOP costs and optimize insurance — all to help gain access to treatment and care.
“Financial navigators help people diagnosed with cancer alleviate financial stress so they can focus on survivorship and healing,” says Aimee Hoch, MSW, LSW, OSW-C, FACCC, Grand View Health Cancer Center’s Financial Navigator.
Aimee created her position at Grand View to meet patients’ unmet needs. As an oncology social worker for years, Aimee had observed that “while people were understandably distressed by the physical aspect of the disease, for many patients, the physical strain was compounded by the emotional stress of how to pay for treatment or even household bills.”
A financial navigator (or social worker) can help by identifying resources for you, which may include:
Note: Many FAPs require you to apply to Medicaid before they consider you. The programs have staff who can help you apply for Medicaid or ask you to do so on your own and let them know the outcome.
Your employer may have someone on staff in the human resources (HR) department whose job is to manage cases that involve medical benefits. If you get your insurance through an employer, contact HR to see what support they can provide.
Prescription medicines often make up a large part of medical costs. If you have limited income or a health plan that has a high deductible or very high copays, covering cancer prescriptions, such as anti-nausea medicine, can become even more challenging.
Resources that can help you pay for prescription medicines include:
Foundation copay assistance, including Patient Advocate Foundation, CancerCare Co-Payment Assistance Foundation, and others offer help.
Copay card programs are often offered by drug manufacturing companies to help people with private insurance pay copayments for the medicines these companies make.
Patient Assistance Programs (PAPs) give discounted or free medicines to those who qualify. PAPs are available through pharmaceutical manufacturers (and are also called “free drug programs”). Your social worker, financial navigator, nurse, or doctor should be able to find out if you qualify.
Medicare Part D Extra Help Program helps with deductibles and copays for prescriptions.
Your doctor may suggest generic medicines or give you samples. Generic medicines are usually less expensive than brand-name medicines. Samples allow you to try a medicine before you buy the full prescription. Once a prescription is purchased, it can’t be returned.
Ask about over-the-counter (OTC) medicines that may produce the same results as your prescription. Find out if the OTC options cost less.
Some charge less than others for the same prescription. Take the time to compare and find the best price. Think about mail-ordering several months’ worth of a prescription if the copay is lower.
If your insurance allows you to use local pharmacies, you may save on copays.
Keep in mind: Many oral treatments are offered only through specialty pharmacies that are contracted with your insurance.
If you don’t have insurance or your health plan doesn’t cover prescriptions, filling only half your prescription at a time may help you save on the up-front, out-of-pocket cost.
Use medicines on your insurer’s preferred drug list, if possible. You may have to pay full price for a medicine that is not covered. Check to be sure your prescription is on the list. If it’s not, you can reassess plan coverage during open enrollment.
Your insurance case manager can help you figure out what information your doctor needs to submit to the insurance company to get your medicines covered.
More resources for help paying for prescriptions are available on our Financial help and resources page.
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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.
