High parking fees at cancer treatment centers can contribute to patients’ financial toxicity, reports a research letter published in JAMA Oncology about a recent cross-sectional study.

Cancer-related financial toxicity is a well-documented burden for many people with cancer, often resulting in the depletion of life savings and even bankruptcy. Unreimbursed costs for treatment play a large role. Researchers have also identified travel and lodging costs as major contributors. But until now, researchers hadn’t looked at how parking costs can compound the problem.

The cross-sectional study examined parking fees at 63 National Cancer Institute (NCI)—designated cancer treatment centers in order to determine parking associated with the treatment of certain cancers: node-positive breast cancer (12 daily rates plus 20 one-hour rates), definitive head and neck cancer (35 one-hour rates) and acute myeloid leukemia (42 daily rates). The data were obtained through telephone calls and online searches from September 1 to December 31, 2019.

Parking costs were obtained for all 63 centers. Twenty centers (32%) offered free parking to all patients. Many other centers offered free parking for radiation appointments or chemotherapy appointments.

But in many cases, parking fees could be quite steep. At centers that charged for parking, rates ranged from $2 to $5 per hour and $5 to $10 per day. The researchers found that the total cost of parking during the course of treatment, including discounts, ranged from $655 for head and neck cancer and $800 for breast cancer to $1,680 for acute myeloid leukemia. Worse, it wasn’t easy to find out the costs beforehand—25 (40%) of the NCI-designated cancer treatment centers did not provide detailed parking costs online.

“Patients may face substantial nonmedical costs through parking fees, even at centers with the highest standard of care,” the study researchers wrote. In addition, due to the lack of information provided online, patients may have difficulty planning for these costs. For financially vulnerable patients, the psychological and economic stress of parking fees may contribute to financial toxicity, which can have a negative impact on their cancer treatment success.

JAMA Oncology reports that previous studies have shown that transportation was the highest out-of-pocket nonmedical cost for patients receiving cancer treatment. Researchers stated, “This study found high variability in costs with the potential for patients to pay hundreds of dollars in parking to receive cancer care. Efforts to minimize financial toxicity may benefit from a focus on this potentially underreported patient concern.”

To read the JAMA letter, click here.

For related coverage, click here and here.