How Can Patients and Their Families Reduce Financial Toxicity?

More Programs and Publications Featuring Dr. Brandy Gunsolus

In this program:

Though genetic testing may be covered by insurance, there are exceptions to be aware of. Medical laboratory scientists Dr. Brandy Gunsolus and Dr. Kyle Riding share key questions to ask before genetic testing occurs and how to prepare for test result outcomes.

Transcript

Leo Hesse:

Now, Dr. Gunsolus and Dr. Riding, this question is for both of you, can each of you share some real world scenarios you've witnessed for patients and families, and tips and how they might mitigate financial toxicity?

Dr. Brandy Gunsolus:

Sure, I'll take this one first.

So one thing that you can do to help speed up the process, especially with the financial side, is that most of these companies will have their financial applications that you can fill out before the testing is even collected, so you can fill that out, you can see exactly how much it's going to cost or is it going to be paying before you can even agree to have that testing done. Some other things that you need to do before having any genetic testing, whether that is testing somatic testing for your tumors or...especially for germline testing to see if you're a carrier or you have a condition, is that you really need to think about what your reaction is regardless of what the result of the test is going to be. What do you intend to do if you don't have the condition, what do you intend to do if you do have the condition...we've seen a lot of this, especially with BRCA testing, which is breast cancer screening, where a lot of women, they say, “Oh, I can't get this done, I'll get it done.” And then they get results back, and they were not prepared to deal with those results, especially if they're abnormal.

So when it comes to genetic testing, you really need to think about what your mental process and even with your family, what these results really mean before you have that testing done. Kyle?

Dr. Kyle Riding:

While it ties into what you just said, Brandy, I unfortunately, about 13 years ago, and I was still in the clinical space, had the misfortune of working with a family who had had a child born with a potential congenital illness. Now, unfortunately, this patient's provider decided to do some genetic testing that really diagnostically and prognostically, the provider didn't at the time fully know what to do with the data. They just knew it was a new test that isn't to speak ill of a physician by any stretch, made an informed judgment at that moment in time, but because there really wasn't a clear medical need for that test, the family's insurance didn't cover it. And the cost of this was $10,000. And this family could not...what family in many instances in this day and age can afford a $10,000 test when they have a child, they're trying to support where the congenital illness that required a lot of specialized care. So one of the things that I would always advocate for is as a patient, your complete blood counts, your basic metabolic panels, your urinalysis, those screening tests, those are covered by insurance or relatively inexpensive, if you start hearing a provider throw around the term, we need to do some genetic testing.

Ask what type of genetic testing? Ask, will this be covered by my insurance? Can we find out beforehand? Ask, “Can this be sponsored if we can't afford it, and our insurance doesn't cover it?”

And finally, it goes to what you just said, Brandy, you need to ask the question of “What will you do if the result comes back as negative” or “What will come back as positive?” Making sure the physician has a clear plan of action for both ends of that test, which could carry a large cost with it is going to meaningfully compact your care is critical for you as your own self-advocate.

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