Table 1.

Studies of financial assistance programs for cancer patients

Author (location)	Design	Outcomes	Sample	Results
Shankaran et al. [6] (Seattle, WA)	Non-randomized pilot study of an in-person or online financial education course followed by monthly contact with a financial counselor and a case manager for 6 months.	Self-reported financial burden and anxiety about costs	34 cancer patients with nonmetastatic solid tumors	High financial burden and anxiety about costs were reported at baseline by 37% and 47% of patients, respectively [6].
Watabayashi et al. [11] (Seattle, WA)	Non-randomized pilot study	Baseline and 6-month follow-up reports of patient financial hardship using the Comprehensive Score for Financial Toxicity–Patient-Reported Outcomes and caregiver work and financial strain using the Caregiver Strain Index measure	32 cancer patients and 18 primary caregivers for those patients	Financial burden and caregiver stress did not change significantly during the pilot despite the fact that participants received a mean of $772 per household (with an additional $647 for some families with non-medical expenses).
Sadigh et al. [14] (Atlanta, GA)	Non-randomized pilot study	This study used the COST tool as a measure of financial distress at study entry and 3, 6, and 9, and 12-months and tracked the number of issues patients discussed regarding debt, disability, employment, insurance, medical decision-making and psychosocial support.	12 brain cancer patients	At 3 months, five patients who completed a follow-up COST tool measurement showed no significant difference in scores from baseline; two of the total 12 patients completed the COST tool at 12 months, with only one-point difference from initial COST assessment. Patients discussed 12 total issues with counselors, of which 93% were resolved within 6 months, with a total of $15,110 debt relief assistance provided.
Kircher et al. [16] (Chicago, IL)	Two-arm randomized controlled trial	Self-reported financial distress, health-related quality of life, and acceptability	95 patients with advanced solid cancers receiving intravenous chemotherapy	No significant changes in financial distress were found between arms. Seventy-six percent of patients reported having no difficulty understanding the information, suggesting high clarity.
Yezefski et al. [15]. (four hospitals in the United States)	Non-randomized evaluation study	Data on financial assistance and hospital revenue. Outcomes for patients included: annual counts of the number of patients receiving navigation, the amount of assistance, and the types of assistance (free medication, new insurance enrollment and benefit maximization, premium/co-pay assistance, transportation, medical equipment).	Financial navigators at 4 hospitals	Trained financial navigators saved patients $39 million in financial assistance, an average of $3.5 million per observation year [15]. Patients saved an average of $33,265 annually on medication most often through connecting patients to foundations or pharmaceutical assistance programs, $12,256 through assistance with enrollment in insurance plans, $35,294 with premium assistance paid by the hospitals, $3076 through referrals to co-pay assistance programs.