A Pilot Unrestricted Payment Program for Early-stage Cancer Patients: the PAYMENT Trial

Fred Hutchinson Cancer Center (FHCC)

Status: Begins enrollment this month

Conditions: Malignant Solid Neoplasm

Treatments: Other: Electronic Health Record Review; Other: Support; Other: Interview; Other: Survey Administration

Study type: Interventional

Funder types: Other; NETWORK; NIH

Identifiers

NCT06771739

NCI-2024-10341 (Registry Identifier)

UG1CA189974 (U.S. NIH Grant/Contract)

RG1124982

Details and patient eligibility

About

This clinical trial studies whether an unrestricted cash payment program can be used to improve financial and clinical outcomes in early-stage cancer patients with financial concerns. A cancer diagnosis can have poor financial outcomes, and the cost of cancer treatment can lead to high medical debt and financial hardships for the patient and family. Financial hardship during cancer treatment is associated with adverse outcomes including poorer quality of life, lower treatment compliance, more aggressive use of hospital-based care, and worse survival. Newly diagnosed cancer patients with financial concerns may avoid treatment entirely so that they can continue to work and maintain income, provide for their families, or pay rent. An unrestricted cash payment program provides patients with a preloaded cash card once monthly. The patients can choose what to use the card to pay for and may include items like food, rent, or utilities. This provides a period of guaranteed income for the patients and may prevent them from falling into poverty and improve financial and clinical outcomes.

Full description

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive a $1000 preloaded cash card once monthly for 3 months.

ARM B: Patients receive a $100 preloaded cash card once monthly for 3 months.

After completion of study intervention, patients are followed up 3 months and 6 months post randomization.

Enrollment: 20 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Age >= 18
• Ability to understand English
• Ability to understand and willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants
• Within 90 days of a non-metastatic or early-stage solid tumor receiving or rescheduled to receive treatment in the neoadjuvant, adjuvant or definitive setting for curative intent. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
• Current cancer patient at PeaceHealth (Southwest Medical Center or St. Joes)
• Not current Medicaid enrollee
• Not enrolled in hospice
• Screens positive for financial fragility

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

Arm A (high payment schedule)

Experimental group

Description:

Patients receive a $1000 preloaded cash card once monthly for 3 months.

Treatment:

Other: Survey Administration

Other: Interview

Other: Support

Other: Electronic Health Record Review

Other: Support

Arm B (low payment schedule)

Active Comparator group

Description:

Patients receive a $100 preloaded cash card once monthly for 3 months.

Treatment:

Other: Survey Administration

Other: Interview

Other: Support

Other: Electronic Health Record Review

Other: Support