Implementing and evaluating medication assistance programming in metastatic breast cancer

With cancer care costs rising rapidly, patients are often burdened by the cost of their treatments, yet financial toxicity is rarely discussed in the clinic setting, and many patients and providers have little guidance as to where to turn for assistance with this burden.  As a result, many cancer patients and their families face difficult decisions on their own, foregoing, skipping, delaying, or discontinuing potentially life-prolonging cancer therapies in light of competing financial demands.  Medication assistance programs directly serve patients to help them afford treatment, but these programs are often unknown to patients and providers, unequally distributed across geographic regions, cumbersome to use, ineffectively coordinated, and/or logistically difficult to navigate.  

In this study, clinicians and public health investigators will partner with HarborPath, a non-profit organization serving uninsured and underinsured individuals, to adapt for the metastatic breast cancer (MBC) setting a successful existing medication assistance program that can effectively coordinate services and fill the medication gap in a timely manner.  Our overarching goal is to develop medication assistance programming that optimizes outcomes for MBC patients (MBCPs) and can be disseminated regionally and nationally. 

Our specific objectives are to: (1) assess medication needs and financial toxicity among MBCPs; (2) map the processes by which patients, their caregivers, and their providers attempt to access financial support; and (3) develop a rigorous implementation and evaluation plan for expanding a novel medication assistance program in the context of existing care coordination and navigation services.