Related Announcements

PAR-20-052: NCI Small Grants Program for Cancer Research (R03 Clinical Trial Optional)

PAR-21-190: Modular R01s in Cancer Control and Population Sciences (R01 Clinical Trial Optional)

PAR-21-035: Cancer Prevention and Control Clinical Trials Grant Program (R01 Clinical Trial Required)

PAR-20-077: NCI Program Project Applications (P01 Clinical Trial Optional)

PAR-21-341: Exploratory Grants in Cancer Control (R21 Clinical Trial Optional)

PA-20-195: NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)

Issued by

National Cancer Institute (NCI)

Purpose

The purpose of this Notice of Special Interest (NOSI) is to promote intervention research through investigator-initiated applications that aim to study ways to mitigate financial hardship for individuals impacted by a cancer diagnosis, including patients receiving cancer treatment, survivors, and caregivers.

Background

The 2021 Annual Report to the Nation on the Status of Cancer estimated the annual patient economic burden of cancer care to be $21 billion in 2019. Part of that burden is felt as financial hardship for patients. Financial hardship refers to the collective impact of out-of-pocket costs and lost income, psychological worry about finances, and behavioral coping responses that include delaying or foregoing recommended care and other necessities to save money. Cancer-related financial hardship is the product of varied risk factors, including rising prescription drug prices, changes in private health insurance benefits that shift healthcare costs to patients through higher co-pays and deductibles, increased out-of-pocket costs, increasingly multimodal treatments, and supportive care therapies delivered by an array of providers. Recent national data indicate that more than half of cancer survivors report material and/or psychological financial hardship. The consequences of financial hardship are wide-ranging and can result in diminished quality of life for patients and their families and, in extreme cases, premature death.

Patients with fewer financial resources to buffer the high cost of cancer care are especially vulnerable to cancer-related financial hardship. Further, those patients most at risk for financial hardship are also less likely to have access to paid sick leave, flexible work schedules, and other accommodations, leading to higher rates of job loss. Thus, the growing financial burden associated with cancer care will likely exacerbate existing disparities in both care and health outcomes.

Although there is a growing body of literature that has established the impact of financial hardship on select patient outcomes, development, and testing of interventions to mitigate patient financial hardship is needed. Additionally, there remain noteworthy barriers to addressing patient economic concerns for individuals treated both in academic cancer centers and the community. These barriers include a lack of transparency regarding the cost of treatment, unclear pathways or workflows to connect patients with financial services, and substantial time and resources required to provide financial services for patients. Research is needed to advance interventions to address these important challenges and mitigate poor patient health outcomes.

Research Objectives

This notice invites research applications that propose to develop and/or test interventional approaches to prevent and/or mitigate financial hardship in individuals diagnosed with cancer. Intervention targets may include the patient, caregiver, clinician, healthcare team, and/or healthcare delivery system, with multi-level research encouraged. Proof of concept and studies testing the efficacy of interventions are acceptable; however, proposed studies should address the potential for intervention sustainability and scalability. Research studies that integrate expertise from diverse scientific and clinical areas (e.g., health services, health economics, outcomes research, health communications, social work, pharmacy, nursing, and oncology) are of particular interest. Studies that target populations identified to be at risk for health disparities are strongly encouraged.

Areas of research interest include, but are not limited to:

• Develop and test interventions to facilitate systematic financial hardship screening in cancer-related care delivery settings.
• Develop and test interventions to innovate the workflow linking patients to financial services, and/or reduce resource burden in providing financial services.
• Implement and evaluate evidence-based strategies to mitigate out-of-pocket costs and their influence on cancer-related care during diagnosis, treatment, follow-up, and/or survivorship.
• Implement and evaluate patient, provider, healthcare system, and/or community-level interventions to mitigate the impact of financial hardship and employment disruption and enhance health equity.
• Develop and test tools that enhance patient and clinician communication related to the direct medical or non-medical costs of cancer-related care and supportive care or communication about financial hardship more broadly.

• Develop and test interventions with populations at increased risk for cancer-related financial hardship and who experience health disparities (e.g. racial/ethnic minorities, rural residents, sexual and gender minorities, socioeconomically disadvantaged individuals).

• Implement and evaluate interventions to improve cost transparency of treatments and healthcare services delivered to cancer patients and survivors.

Application and Submission Information

This notice applies to due dates on or after April 1, 2022 and subsequent receipt dates through March 1, 2024. 

Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcements through the expiration date of this notice.

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

For funding consideration, applicants must include “NOT-CA-22-045” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Although NCI is not listed as a Participating Organization in all the FOAs listed above, applications for this initiative will be accepted.

Applications nonresponsive to terms of this NOSI will be withdrawn from consideration for this initiative.

Inquiries

Scientific/Research Contact(s)

Kathleen Castro, RN, MS, AOCN
National Cancer Institute (NCI)
Telephone: 240-276-6834
Email: kathleen.castro@mail.nih.gov
 

Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).

Financial/Grants Management Contact(s)

Dawn Mitchum
National Cancer Institute (NCI)
Telephone: 240-276-6282
Email: dm437a@nih.gov