Individual abstract within a Delegate Designed Symposium Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Identification of policy levers to address financial toxicity in people affected by cancer: a scoping review   (142726)

Ashleigh R Sharman 1 , Jordana McLoone 2 , Carla Thamm 3 , Laurelie Wishart 4 , Sue Woodall 5 , Raymond Chan 3 , Megan Varlow 6
  1. Leeder Centre for Health Policy, Economics and Data, The University of Sydney, Sydney, NSW, Australia
  2. School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW, Sydney, NSW, Australia
  3. Caring Futures Institute, College of Health and Enablement, Flinders University, Adelaide, SA, Australia
  4. School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
  5. Live-Work-Cancer Ltd, Sydney, NSW, Australia
  6. Faculty of Health, Deakin University, Melbourne, VIC, Australia

Aim: Extending well beyond medical costs, financial toxicity, defined as the combined impact of direct out-of-pocket costs, indirect costs and changing financial circumstances, adversely effects treatment adherence, quality of life, psychological distress, and long-term health outcomes among people affected by cancer. Policy-based and system-level strategies have the potential to mitigate financial harm at scale. The objective of this scoping review was to understand the policy-level supports and mechanisms that currently reduce or could be adapted to reduce financial toxicity for people affected by cancer in the Australian setting.

Methods: Guided by the Joanna Briggs Institute framework, a scoping review of Australian health, social services, and welfare system policies were searched within electronic databases (MEDLINE (PubMed), CINAHL (EBSCO), Embase, Scopus, PsycINFO, Overton) from the last 10 years. Sources of grey literature were searched using Google. Policy documents and legislation current within the Australian setting were included. Screening of eligible results was conducted by two independent reviewers in Covidence, and disagreements resolved by discussion within the research team. Using a rational inductive approach, search results were also discussed with an expert working group prior to data extraction which identified and mapped policy-level supports and mechanisms.

Results: Preliminary results have identified national and state funded supports and mechanisms that may be accessed by patients and carers across the cancer care continuum. These include medication thresholds, travel rebates, prostheses reimbursements, allied health subsidies, financial counselling, social welfare payments and early access to superannuation. Of note, most of these were not specific to the context of cancer, rather to chronic disease more broadly.

Conclusions: Addressing financial toxicity is a critical component of comprehensive cancer care. By identifying policy levers for advocacy action and research enquiry within Australian public health, policy and political discourse, we can move toward a sustainable approach to cancer treatment, and survivorship.