For a conversation produced by our underwriter, Takeda, about paying for cancer care, please welcome Carla Tardif, the CEO of Family Reach, here with Dion Warren, the head of US oncology at Takeda. 

Dion Warren: It’s wonderful to be here with you today as well as with Carla. We’re here to talk about a very important issue, financial toxicity. 

So, before I ask Carla a question or two, I’d actually like to ask you in the room and at home a question. When you think of financial toxicity in cancer and in healthcare, do you think of medicine costs and drug costs, by show of hands? Yes, yes, yes. All right, it’s a reasonably common sentiment. 

What I want to focus on today, our financial toxicities go well above and beyond medicine costs. I’m talking about financial toxicity and disparities in health inequities, areas like transportation, like food, like housing. This is the reality that we face. It’s a vast and important topic, one that takes society to make an impact and focus on. And I’m very proud to work with Carla here. Carla’s been an originator in the health disparities and equity space, and we’re talking about people — people with cancer — that happen to also struggle with transportation, food, and housing, etc. These are the real priorities that patients must deal with. 

So, with that, I’d like to turn over to Carla to tell us a little bit about Family Reach. 

Carla Tardif: Thank you, and it has been such an honor to work with you all these years. Takeda has certainly been an early adopter in this not talked about, highly shameful side of cancer, and that is the financial crisis of cancer. 

Family Reach has been around for 26 years. So, health disparities, not a new problem, but certainly one that is now making its way into headlines, and I am so beyond grateful for that because now we can make some change. You heard Danielle from the Moonshot say there are 600,000 cancer deaths a year. One third of cancer deaths in this country could be prevented by addressing socioeconomic disparities, by removing financial barriers, and that’s what we do and have done for 26 years. 

So, Family Reach, again, is solely focused on removing financial barriers. We do that through heavy resource navigation. There are so many resources for cancer patients to help them with their financial barriers, but they don’t know about it because there is so much shame in raising your hand and saying, “Wait a second, I’m having trouble making ends meet. My cancer care will suffer because of that.” 

We offer financial assistance. We step in with the non-medical bills — housing, heat, utilities, gas, food — because until those basic needs are being covered for your family, Maslow’s hierarchy of need, your cancer is going to take a backseat. So, we are the financial care team that needs to work with the medical care team to give that true patient-centric experience and increase their chance of survival. 

Dion Warren: Wonderful, Carla. I can attest to the phenomenal work that Carla and her organization do for patients. Based on your experience, Carla, can you bring to life a little bit the type of people and where you see these financial toxicities? And I’d love also to bring those stats to life, hear some case studies and some specific examples of what you see. 

Carla Tardif: Yeah, no, I appreciate that question because you hear “cancer patients are 2.65 times more likely to file for bankruptcy. Those that do have a 79 percent higher mortality rate.” Why? Well, 31 percent are cutting their meds in half. 

I want to tell you about a single mom that we have with three children. She was feeding all three of her children the prescription formula meant only for her infant with leukemia. It was the only food she had. 

We have a mother with triple negative breast cancer. She’s a mother of seven. She couldn’t work during treatment. She actually saw that she was bankrupting her family, and she called her social worker and said, “I’m taking myself off treatment. I’m going to bankrupt my family.” They put her in touch with Family Reach, and we were able to step in with these resources of a financial planner. So, people are making the decision to not continue with treatment because of the financial crisis. 

I’m gonna tell you one more story. I went to visit a family early on, a single mother whose little girl had leukemia, and I went into her home, and she had two sleeping bags in the kitchen, and I said, “Oh, are you playing house?” And she said, “No, we have no heat, we sleep here, and we just turn the stove on for heat.” So, this is where those numbers — this is what it means to people — and we hear this every day. 

Dion Warren: Thank you, Carla, for sharing. That’s reality, folks. That’s bringing cancer to life here and these are the problems that us as society and our people face. 

Can you share with me a little bit — you’ve been in this space for over 25 years, you’ve seen a lot, a lot more than any of us combined — so can you speak to how what you’ve seen has evolved? Maybe what did the space look like 10 years ago? What are the types of challenges that you’re seeing today, right now, across the US? 

Carla Tardif: Right. So, I did not start Family Reach, although I act like I did, because I have been doing this work for 15 years. It was started by two families in New Jersey who both lost their children to cancer, and in the hospital, on the floors, getting to know families, they were hearing this — this strife, this “we can’t go home, there’s no heat.” “My neighbor just called, there’s a repo guy in the driveway. I cannot go home, they will take my car, we can’t get back to treatment.” 

So, I lost a friend to brain cancer, who I went to Syracuse University with. He played for the Jets, and he too said he would visit the kids’ pediatric floors, and he said, “Oh my God, there’s this whole other battle of cancer that is going on that nobody is talking about,” and it was literally my deathbed promise to him that I would fix it. OK, so I didn’t know what “it” was before I promised to fix it, because clearly it is way bigger than one organization or one company can accomplish together. 

But that was 15 years ago, and I dove in headfirst, and I would tell people what I did and they just kind of looked at me cockeyed and said, “Well, doesn’t the hospital do that?” or “Don’t they have insurance?” Like, how in one of the wealthiest countries in the world, how is this happening to people with cancer? 

So to answer your question, times are changing and I do feel really hopeful that through collaboration and through awareness people understand this human side of cancer, because science — what so many of you do — is so much harder than what I do, but science is far outpacing that patient’s reality, so together we can make a difference. 

Dion Warren: Wonderful. And I’d love to build on that because I think it’s a perfect sentiment. No one company, no one organization are going to solve this. It’s going to take society. Can you share perspectives — we have a very diverse group of folks in this room that have very different experiences — how can we attack this problem and make a real true impact at the local patient level? How can we do that? Any advice? 

Carla Tardif: Yeah. How much time do we have? Lots of advice. So, thank you all, even just for giving us the time to again shed light on this really harsh reality of cancer. 

The pharmaceutical industry has been a great partner of ours for many years because we affect their ability, or patients’ ability, to access care, adhere to treatment, and stay on treatment. But there are other partnerships that need to happen. We partner with nonprofits, who many advocacy organizations say the number one call into our call center is for financial crisis. We want to work with you. We want to offer — we have over 10,000 financial resources that we are navigating patients to. We want to share that. 

We have a financial guidebook that starts to wipe out the shame and says, “You did nothing wrong. This is cancer. Here’s a roadmap. Here’s how to talk about it. Here’s who to talk about it with.” So, partnerships with nonprofits, more partnerships with pharma, partnerships with housing and utilities companies. We work with food delivery programs. Hunger is a huge problem for cancer patients, especially during COVID — delivering healthy, pre-cooked meals to their home, getting them set up on SNAP benefits. 

So, this isn’t just a healthcare issue. This is something that we want to work with housing, transportation, food, and utilities on for that full wrap-around service for the cancer experience. 

Dion Warren: Well Carla, thank you. I can feel your passion. I share it with you. I think there’s a lot of folks in the room that share it with you. You have my commitment that we can do better and make an impact. Family Reach has been an amazing partner. Carla herself has made a tremendous impact, and I look forward to continuing our partnership together. Thank you, Carla. 

Carla Tardif: We can fix this. Let’s do it. 

Dion Warren: All right, thank you. Take care, everybody.