Why Breast Cancer Patients Need Pink Fund Now More Than Ever

A few years ago, I worked at a hospital in a rural area on the boarder in between Virginia and North Carolina. I met Anna*, a 38-year-old woman who had been hospitalized to undergo her first round of chemotherapy for an aggressive form of breast cancer. She had been referred to me because she didn’t have insurance and was going to need assistance with her medication related costs from what was just the beginning of her long battle with breast cancer.  

The hospital was about an hour and a half away from the Outer Banks, a chain of barrier islands off the coast of North Carolina known for its wide, sandy beaches and lots of tourists. Anna worked 8-10 hour shifts everyday cleaning condominiums located on various rental properties. I didn’t have the heart to tell her right after her diagnosis that once treatment started, she was going to have a tough time keeping up with such a physically demanding job. So, I did what I knew how to do… I helped her apply for Medicaid and while waiting for that lengthy process, I also accessed every manufacturer free drug program I could. 

I continued to stay in touch with her in between treatments and visited her at each cycle in the infusion center. At cycle 3 of 6, she told me that she just didn’t have the energy to keep climbing stairs and working for a full 8-hour day. It broke my heart when she said she didn’t have a choice so she continued to drive an hour to her job and back for as long as she could. Although Anna was uninsured, this story is all too familiar for many women with breast cancer who end up decreasing their hours at work and jeopardizing their health care coverage. 

The National Cancer Institute (NCI) defines cancer related financial toxicity as “problems a cancer patient has related to the cost of treatment”. The NCI is a great organization, but that definition doesn’t give “financial toxicity” the sense of urgency it deserves. And how does breast cancer uniquely create financial toxicity? 

• Breast cancer tends to be diagnosed during the highest wage-earning times of a woman’s life and during the critical time of raising and caring for a family. 
• Most breast cancer patients are dependent upon employment-based insurance. 
• Breast cancer patients are treated with a combination of therapies such as surgery, chemotherapy/immunotherapy, radiation therapy and supportive care.  
• Patients have costs not covered by insurance companies such as childcare and transportation costs to and from treatment. 
• Women with metastatic breast cancer can have received multiple courses of treatment given the long natural history of breast cancer.
• More treatment combinations have become available, and these newer therapies have resulted in extended survival and increased financial hardship. 

I’m no economics major so I’m going to describe inflation in terms that even I can understand. Inflation occurs when the value of the dollar goes down and the price of goods and services goes up. Inflation rose by 7% in 2021 and another 6.5% in 2022 as compared to just 1.4% in 2020. So how does this ultimately impact our patients? Well, unfortunately, it’s a snowball effect. 

As the cost-of-living increases, many landlords may raise the rent to keep up. Labor shortages due to COVID-19 have contributed to the increase in food prices. Higher employee wages are reflected in increased menu prices. I think we all gasped at the price of gasoline last summer and now we’re struggling with soaring electricity bills.  

At the end of last year, many people faced multiple options for health insurance during open enrollment season. When people have sticker shock from eggs alone, you can probably see how tempting it is to want to decrease the amount of your monthly health care premiums. Unfortunately, that premium decrease comes with much higher deductibles and out of pocket expenses for health care. You convince yourself you’re pretty healthy and you take your chances. You can see already where the options to make tradeoffs between health care and living expenses occur. So, what happens if you do get sick and specifically, get diagnosed with breast cancer?  

As a financial navigator, if you have commercial insurance, I can secure manufacturer copay assistance on your behalf, but only for drugs that have programs available. If you’re uninsured, I can most likely get you free drug. But breast cancer patients are still left with several treatment related expenses that drug manufacturers can’t help with. Independent foundations such as Healthwell or PAN have funds for transportation and even for insurance premiums, but they’re competitive…and by competitive, I mean when I get a text saying that the breast cancer premium fund is open, I pull off on the side of the road and use my hotspot to enroll you into that breast cancer fund type of competitive! 

Luckily for my patient, Anna, I had recently learned about Pink Fund, a nonprofit organization that directly paid bills for living expenses, so patients don’t have to choose between paying their medical bills or their mortgage. It didn’t cover everything, but when we combined all the types of available assistance, it gave her some breathing room and she was able to cut back her hours at work until her disability and Medicaid kicked in.  

I wish all my patients had stories with good outcomes like this, but unfortunately there are many variables about our health care system outside of my control. I wrote this blog not just to shine light on the specific hardships that breast cancer patients face, but also to thank Molly MacDonald, the founder of Pink Fund, who has lived this story and now dedicates her life to helping women like Anna.  

Jerilyn Arneson is the Director of the Sales Solutions Support Team at CoverMyMeds and has been a practicing pharmacist for 24 years. She used her combined skills as a Board Certified Oncology Pharmacist, a Revenue Integrity pharmacist and a Certified Medicare Benefits Counselor to create financial navigation programs at several hospitals and health systems. Jerilyn is also a cofounder and board member of the National Association of Medication Access and Patient Advocacy (NAMAPA) and teaches other financial advocates how to lower patients’ out of pockets costs from their treatment of cancer or other chronic diseases.