Public Health
Cancer’s hip pocket toll
The frightening disease brings enough physical and emotional pain without the accompanying shock of unexpected bills.
Sydney teacher Megan Solis never counted the financial cost of the treatment her late husband Antony received during his three-year struggle with bowel and liver cancer.
Keeping track of the sizeable out-of-pocket treatment costs – from diagnosis until Antony’s death at the age of 41, in August 2018 – was the last thing on Megan’s mind.
Megan worked throughout most of Antony’s illness while raising their children Isaac, now 8, and Minnie, who is 5.
With her wage, and their savings, the couple found the many thousands of dollars needed to meet unreimbursed expenses for consultations, scans, medicines and even chemotherapy.
“I had no idea how steep the out-of-pocket costs could be, even for a public patient as Antony was,” she says.
“I was working full time, we had a bit of savings and a lovely family and friends who helped us out.
“I have no idea how someone who is by themselves and in a worse financial situation, is able to manage.”
Some out-of-pocket costs will be eliminated under federal Labor’s plan to expand Medicare coverage of scans and consultations and put more drugs on the Pharmaceutical Benefits Scheme.
Megan welcomes the plan and hopes it will ease the financial burden on cancer sufferers in future years.
Antony was treated at St Vincent’s Hospital’s Kinghorn Cancer Centre in Darlinghurst from late 2015 to early 2017.
“Other than an initial consultation and one or two scans, treatment through Kinghorn was mostly free,” Megan says.
To be closer to home, Antony transferred to the Chris O’Brien Lifehouse cancer centre, a not-for-profit facility in Camperdown.
The state government has paid Lifehouse to treat public patients since it took over many of Royal Prince Alfred Hospital’s cancer services in 2013.
“I was shocked to find that we had to pay for chemo at Lifehouse, even as a public patient,” Megan says. Antony’s fortnightly chemotherapy dose cost them between $100-$150.
Other out-of-spocket expenses included over-the-counter anti-nausea drugs, which could cost several dollars a day, and Antony’s liquid diet in the final weeks of his life.
A Lifehouse doctor prescribed medicinal cannabis, which is not covered under the PBS and cost $400 for a three to four-week course.
Medicinal cannabis was “amazingly beneficial for Antony but would be cost-prohibitive to many people,” Megan says.
Antony chose to spend the last eight days of his life with his family, at home.
However, the decision not to die in hospital cost more than $1000 in out-of-pocket expenses ranging from delivery and return of the hospital bed to pain-killing injections.
“We found we had to pay for all the drugs that would have been free had Antony gone into palliative care in hospital,” Megan says.
“Antony’s oral medications were covered by the PBS – we only paid a few dollars a dose. But when he could no longer swallow, and I had to administer his medicine subcutaneously, we had to pay anything from $40 to $120 a pop.
“I dropped $200 to $400 every time I went to the chemist – it was crazy.”
Megan says it’s ironic that if Antony had chosen to die in hospital he would have taken up a room and been fed and cared for by nurses at much greater cost to the taxpayer.
“The nurses who came to our house were wonderful. But even taking their costs into account, I’m sure that would have been a cheaper option for the government than taking up a bed in the palliative care unit.
“Being able to die at home was much better; everyone should be allowed to do that. But it shouldn’t cost the patient more than staying in hospital.”