First Intervention on Financial Toxicity in Gynecologic Oncology

  • Clinical Transformation,
  • Health Equity,
  • Payment Models & Affordability
Project Status: In Progress

This project introduces a financial navigation program to mitigate financial toxicity and provide support for patients with gynecologic cancers during treatment. Pending findings, this intervention can improve care outcomes for up to half of all gynecologic oncology patients.

Gynecologic cancers are the third most common cancer in the United States. While advances such as multi-modal therapeutics have had a positive impact on care and overall survival, insurance coverage of these new treatments has lagged behind. Even patients with insurance face barriers to affording care, and patients with gynecologic cancer spend on average upwards of $5,000.00 annually on out-of-pocket expenses related to their treatment. In fact, 50% of all patients with gynecologic cancer experience financial toxicity, which can include anything from high copayments to missing work for treatment.

When patients experience financial toxicity, they often need to borrow money, delay treatment, or miss medications. Gynecologic cancer patients with severe financial toxicity are seven times more likely to delay care and are thus less likely to complete multi-modal treatments on time, which worsens overall survival. Furthermore, the chances of experiencing financial toxicity increase significantly for patients who identify as Black or Hispanic, have Medicaid or Medicare, or have lower incomes.

This study will implement the first intervention on financial toxicity in gynecologic oncology with the provision of enhanced social work support and financial navigation for gynecologic oncology patients. Through these services, patients who are at risk of financial toxicity will be proactively identified, and social workers and financial navigation officers will then work alongside them to mitigate financial toxicity during treatment. Through the use of a baseline survey and pre-post implementation analysis, the team will evaluate feasibility, acceptability, and usability of this intervention.

As the first ever intervention on financial toxicity in gynecologic oncology, this ongoing study will have implications for the feasibility of financial navigation interventions and for scalability in gynecologic cancer care. If effective, it could mean improving care outcomes for up to half of all gynecologic oncology patients.

Project Leads

  • Anna Jo Smith

    MD, MPH, MSc

    Instructor, Gynecologic Oncology, Perelman School of Medicine

  • Emily Ko

    MD, MSCR

    Assistant Professor, Obstetrics and Gynecology, Perelman School of Medicine

  • Meredith Doherty

    PhD, LCSW

    Assistant Professor, School of Social Policy and Practice

  • Justin Bekelman


    Director, Penn Center for Cancer Care Innovation

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