# Characterizing and Addressing the Financial, Time, and Administrative Burdens of Cancer and its Care

## TL;DR

This paper discusses the non-physical challenges like financial, time, and administrative burdens faced by cancer patients and caregivers, and how these impact their experiences and outcomes.

## Contribution

The paper introduces the concept of a triad of non-physical 'toxicities' in cancer care and emphasizes their interconnected and compounding nature.

## Key findings

- Financial, time, and administrative burdens are significant and interrelated challenges in cancer care.
- Addressing one type of burden can inadvertently worsen another, such as reducing financial costs by increasing time and administrative efforts.
- The paper calls for oncology practice to routinely consider and manage these burdens to improve patient and caregiver well-being.

## Abstract

The success of cancer care delivery must be evaluated not only by efficacy outcomes such as overall survival, but also by the experiences of patients and their informal caregivers throughout the course of care. Financial, time, and administrative burdens constitute a triad of non-physical “toxicities’’ that greatly affect patient and caregiver experiences—and outcomes— and should be routinely considered and addressed in oncology practice. While all these burdens have been ever-prevalent, the increasing complexity of cancer care has made these issues more relevant over time. Financial and time burdens started receiving mainstream attention in the oncology community circa 2010 and 2020 respectively. Administrative burdens are currently less well defined but are increasingly recognized and consequential. Each component of the triad does not exist in isolation—financial, time, and administrative burdens can overlap with, interact with, and compound each other. Attempting to address one may worsen another—for example, transferring a medicine prescription and driving to another pharmacy 20 miles away where the co-pay is $50 lower may reduce direct medication out-of-pocket costs, but increase both time and administrative burden. The current piece summarizes the current status of the field with the hope it galvanizes the oncology community to understand and manage these burdens, so patients and caregivers can live their fullest lives.