OBJECTIVES: Patient out-of-pocket cancer treatment costs can be considerable in the United States (U.S.) resulting in the recently described adverse event, financial toxicity (FT). FT is the adverse impact of a cancer diagnosis or treatment on a patient’s financial well-being due to the treatment cost, travel time, and/or employment status. In the recent PRO-TECT trial, which assessed FT screening in oncology practice, found that routine screening along with communication of concerns to the clinical team resulted in patient benefits (e.g., prevented increased FT). Biosimilar drugs may reduce total cost of care and FT. In October 2022, the Inflation Reduction Act increased Medicare payment to physicians for qualifying biosimilar infusions, thus incentivizing consideration where appropriate. We conducted research to understand physician perceptions around FT and the role biosimilars may play in its reduction.

METHODS: Survey questions were administered to U.S. community oncologists at an in-person summit in November 2022. Results are analyzed with descriptive statistics. Not all summit attendees responded to every survey question.

RESULTS: Respondents (N=56) reported their primary specialty as hematology oncology (61%) or medical oncology (39%) and had an average of 20 years in practice. Less than half of respondents (40%, 21/53) stated they measure FT in their practice. Predominate barriers (N=51) to financial/cost-related conversations with patients were lack of time (59%) and lack of resources (37%). However, patient out-of-pocket cost (61%, 33/54)) was one of the top non-clinical factors in treatment decisions, with a majority of respondents (75%, 39/52) “very likely” to prescribe a generic/biosimilar over brand drug/biologic.

CONCLUSIONS: While increased screening and communication around FT may benefit patients, it is evident that treating physicians have continued barriers to implementation. Oncologists are aware of costs and patient FT when creating treatment plans, specifically when considering prescribing biosimilars.