title: Patient and oncologist discussions about cancer care costs.
abstract: OBJECTIVE
  Patient out-of-pocket costs are higher for cancer care than for any other health-care sector. Oncologist-patient discussions of costs are not well understood. We conducted an exploratory interview study to examine the frequency, patterns, attitudes, and preferences of both patients and providers on discussion of treatment costs.
  
  
  METHODS
  We conducted semi-structured telephone interviews with oncology clinicians and people receiving chemotherapy at a large nonprofit health system. Multiple investigators conducted thematic analysis using modified content analysis, grounded theory, and interaction analysis methods.
  
  
  RESULTS
  Patient themes included the relevance of cost to their experience, preference for the doctor to be the starting point of cost discussions, but relative infrequency of discussions with doctors or other care team member. Provider themes were an emphasis on clinical benefit above costs, conviction that cost-related decisions should rest with patients, and lack of access to treatment costs. Interest in discussing costs and barriers accessing cost information were common themes from both patients and providers.
  
  
  CONCLUSIONS
  Doctors and patients want to discuss treatment costs but lack access to them. These data support growing evidence for a provider role in discussions of cost during cancer treatment planning.
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA, henrikson.n@ghc.org.
authors.forename: Nora B
authors.initials: NB
authors.lastname: Henrikson
authors.forename: Leah
authors.initials: L
authors.lastname: Tuzzio
authors.forename: Elizabeth Trice
authors.initials: ET
authors.lastname: Loggers
authors.forename: Janice
authors.initials: J
authors.lastname: Miyoshi
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
mesh_terms: D000328:Adult; D000368:Aged; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000191:economics*; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000628:therapy; D011795:Surveys and Questionnaires