Communication about cost of cancer care: Attitudes and practices of oncologists.

e18826 Background: With the cost of cancer care rising, it is becoming ever so important for physicians to be mindful of financial toxicity to their patients. Patient-provider cost discussions are associated with lower out of pocket costs (Hong el al, Value in Health 2020), yet few patients report having this discussion with their physician. There are few reports on oncologist’s preparedness, current practice, and barriers in discussing costs with their patients. Methods: An online survey was administered to hematology/oncology faculty physicians and fellows at the IU Simon Comprehensive Cancer Center. The objectives were to assess attitudes on communication about cost of cancer care and awareness around financial toxicity of cancer therapy. The questions included physician perception on patient’s attitudes towards cost discussion in clinics, current state of cost discussion in their clinic and their preparedness on having this discussion in the future. Results: 27/48 (56%) fellows and faculty members completed the survey. All respondents believed cost communication is associated with improved patient outcomes and 82% believed cost communication is desired by most patients. 22/27 (81%) indicated cost of care were discussed in less than half of patient encounters. 22/27 (81%) believed clear communication about cost should be a part of the patient’s clinic visit. When asked to rate their preparedness level on a scale of 0-100 on discussing cost of cancer care in their clinics, the median preparedness level was 20. Median awareness level about patient’s insurance plan was 20 and median awareness level about patient out of pocket cost was 21. 26/27 (96%) believed knowing cost of therapy and out of pocket cost would change the way they practice. 20/27 (74%) reported that not knowing the cost of cancer care themselves was the greatest barrier behind not discussing costs. Conclusions: Despite believing cost of cancer care should be discussed in the clinic, most hematologists/oncologists surveyed did not do so. Physician education on cost of cancer care and patient out-of-pocket costs is greatly needed.