Cancer patients aren’t just battling a deadly disease—part of their time and energy can also be spent fighting the system intended to cure them, a new study says. The findings are published in the journal JCO Oncology Practice.
Half of cancer patients who needed prior insurance authorization for their care had to directly involve themselves in the process, researchers reported at the American Society of Clinical Oncology’s Quality Care Symposium in Chicago.
The results, researchers said, included treatment delays, financial strain and personal stress that could potentially affect their odds of survival.
“Cancer patients and their families are being pulled into the insurance prior authorization process, at the expense of their time, health and well-being,” lead researcher Alexandra Zaleta, vice president of research and insights at CancerCare, a professional support service for cancer patients, said in a news release.
“While doctors and care teams often take the lead, half of patients told us they also had to roll up their sleeves by personally making calls, filing paperwork or chasing down approvals,” Zaleta said.
For the new study, researchers surveyed 1,200 recent cancer patients age 26 or older, of whom 74% needed at least one prior authorization for their cancer care.
Half of those reported direct involvement by themselves or a family member in obtaining their most recent prior authorization. The other half said prior authorization was fully handled by their health care team.
Of those who had to get involved in obtaining a prior authorization:
- 50% spent up to one business day working on it.
- 29% spent up to three business days.
- 12% spent a full business week or more.
Personal involvement in prior authorization differed based on the type of cancer treatment:
- Targeted therapies (73% personally involved versus 27% handled completely by health care team)
- Supportive medications (64% versus 36%)
- Radiation therapy (40% versus 60%)
- Imaging (40% versus 60%)
Certain groups were more likely to become personally involved in obtaining prior authorization, including:
- People younger than 65 on employer-provided insurance (3.7 times greater odds) or Medicare (2 times greater odds)
- Men (2 times greater odds compared to women)
- Patients with advanced cancer (2 times greater odds)
- Patients with delays in diagnosis (66% higher odds) or treatment (54% higher odds)
Cancer patients who had to get involved in their prior authorizations were 23% more likely to report worse physical, emotional and financial well-being, researchers found.
They also were 21% more likely to report scrimping on medication to save money.
“This study makes clear what many of us in oncology have suspected: Prior authorization isn’t just an administrative hurdle for clinicians, it’s a hidden second job for patients,” Dr. Macin Chwistek, director of supportive oncology and palliative care at Fox Chase Cancer Center in Philadelphia, said in a news release.
“This study found that patients with cancer, particularly younger patients and those with advanced disease, often have to personally navigate the authorization process, leading to delays in treatment and financial and emotional strain,” noted Chwistek, who was not involved in the research.
Researchers plan to continue digging deeper into the study data, to better understand the unique challenges faced by people with employer-provided insurance plans.
More information:
Alexandra Katherine Zaleta et al, Prior authorization: Patient involvement and time burden in cancer treatment., JCO Oncology Practice (2025). DOI: 10.1200/op.2025.21.10_suppl.175
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