Patients’ and oncologists’ perceptions towards the discussion on high-cost innovative cancer therapies: findings from a qualitative study

OBJECTIVES: In the last decades, innovative technologies for cancer treatment were developed rapidly. In most cases, their price is high, with no funding offered by public health systems. The present study examined the perceptions of oncologists, patients and family members regarding the challenges in discussing innovative cancer treatments. DESIGN: Qualitative study, using in-depth semistructured interviews. Interviews examined public versus private financing, therapist–patient–family discourse, modes of decision making and implications on health policy and inequalities. PARTICIPANTS: Sixteen cancer patients, six family members of cancer patients and 16 oncologists participated in the study. RESULTS: Four themes emerged from data analysis: the economic consideration in the decision on cancer treatment, the options of funding high-cost private treatments, psychosocial aspects of the discussion on treatment costs and health policy in oncology and its social aspects. CONCLUSIONS: Findings emphasise the importance of considering costs when recommending expensive care and addressing the emotional element of innovative treatment, as most patients expect. The findings present various psychosocial aspects taking part in the complicated decision to use unfunded cancer treatment and its broad implications, which may use as a basis for developing a guided framework for oncologist–patient discourse.