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J Adolesc Young Adult Oncol. 2019 May 9. doi: 10.1089/jayao.2018.0151. [Epub ahead of print]

Financial Assistance for Fertility Preservation Among Adolescent and Young Adult Cancer Patients: A Utilization Review of the Sharing Hope/LIVESTRONG Fertility Financial Assistance Program.

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1 St. Joseph's Children's Hospital, Paterson, New Jersey.
2 New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
3 LIVESTRONG Foundation, Austin, Texas.
4 Alliance for Fertility Preservation, Oakland, California.
5 Dell Medical School, Austin, Texas.
6 Weill Cornell Medical Center, New York, New York.


Purpose: Fertility preservation (FP) is a critical component of adolescent and young adult (AYA) cancer care that remains inadequately delivered. Prohibitive cost due to a lack of insurance coverage remains a barrier. Since 2004 Sharing Hope/LIVESTRONG Fertility has assisted AYA cancer patients through discounted FP rates and access to free medications. Methods: Demographics, cancer diagnoses, and dollars saved by patients who used the Sharing Hope/LIVESTRONG Fertility program from 2004 to 2011 were retrospectively reviewed and reported using descriptive statistics. Utilization of financial services for the most common diagnoses was compared with the rate of diagnosis among AYAs. Results: One thousand one hundred fifty men and 1301 women received assistance between 2004 and 2011. Median age was 24 years (range, 12-67) for men and 30 years (range, 13-49) for women. Breast cancer, Hodgkin lymphoma (HL), and genitourinary cancers were the most common diagnoses among females; testicular cancer and HL were most common among males. Recipients represented 1245 cancer centers across the United States. Average cost savings was $6587 per female and $386 per male. Program utilization/diagnosis ranged from 0.8% to 2.7%. Conclusion: Utilization of financial assistance for FP was low despite literature pointing to the need for such assistance. Costs for FP for women far exceed those for men. State-specific insurance initiatives are beginning to mandate coverage for FP. As insurance coverage expands, further studies are needed to determine the true financial burden to patients, the degree to which lack of resources prevent FP in this population, and the impact that insurance coverage has on the provision of these services.


fertility preservation; financial assistance; insurance


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