Implementing a Patient-Centered Intervention to Reduce Cancer Patients’ Financial Toxicity (I Can PIC)


Implementing a Patient-Centered Intervention to Reduce Cancer Patients’ Financial Toxicity (I Can PIC)

Project Dates: 2019-2021

Financial toxicity affects up to 75% of cancer patients and survivors in the US. It can impact cancer patients’ quality of life, result in delayed or forgone care, and increase mortality. With support, financial toxicity can be addressed by members of the oncology care team. Yet only about 25% of providers feel prepared to discuss costs with patients.  We previously developed and tested a web-based tool, I Can PIC (Improving Cancer Patients’ Insurance Choices) that helps patients: 1) understand health insurance and how to use it to manage care, 2) talk to providers about care costs, and 3) choose a health insurance plan and identify resources to help offset care costs. A study of an earlier version of the tool  found that those using the tool (vs. those in a control group) had higher health insurance literacy and more confidence using their plan. They were 10 times more likely to choose an insurance plan that matched their health and financial needs. The tool was modified with cancer survivors’ input and evaluated in a randomized trial. Results show promising effects; yet I Can PIC remains in the research setting. Its routine adoption requires modification with stakeholder input and implementation research methods, delivery through the electronic health record (EHR), and testing in a diverse population.

Project Goals:

  • Refine I Can PIC based on stakeholder input and usability testing to prepare it for use in routine care.
  • Evaluate I Can PIC’s impact on newly-diagnosed breast, colorectal, and lung cancer patient care in the BJC system in a pre/post within subjects design.

Implications for Research and Practice:

I Can PIC provides plain language education at an accessible reading level, uses Medical Expenditure Panel Survey (MEPS) data to estimate annual costs across plan types, and allows users to input their plan details to compare costs.

Project Contact: Mary Politi, PhD

Project Staff: Krista CookseyLindsay KurokiChristine MarxAbigail BarkerEsther LuSarah Pritchard