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NCT Number: NCT06771739

A Pilot Unrestricted Payment Program for Early-stage Cancer Patients: the PAYMENT Trial

This clinical trial studies whether an unrestricted cash payment program can be used to improve financial and clinical outcomes in early-stage cancer patients with financial concerns. A cancer diagnosis can have poor financial outcomes, and the cost of cancer treatment can lead to high medical debt and financial hardships for the patient and family. Financial hardship during cancer treatment is associated with adverse outcomes including poorer quality of life, lower treatment compliance, more aggressive use of hospital-based care, and worse survival. Newly diagnosed cancer patients with financial concerns may avoid treatment entirely so that they can continue to work and maintain income, provide for their families, or pay rent. An unrestricted cash payment program provides patients with a preloaded cash card once monthly. The patients can choose what to use the card to pay for and may include items like food, rent, or utilities. This provides a period of guaranteed income for the patients and may prevent them from falling into poverty and improve financial and clinical outcomes.

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Key information

Conditions

Malignant Solid Neoplasm

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

PeaceHealth Saint Joseph Medical Center, Bellingham, Washington, United States

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About this study

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive a $1000 preloaded cash card once monthly for 3 months.

ARM B: Patients receive a $100 preloaded cash card once monthly for 3 months.

After completion of study intervention, patients are followed up 3 months and 6 months post randomization.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age >= 18
  • Ability to understand English
  • Ability to understand and willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants
  • Within 90 days of a non-metastatic or early-stage solid tumor receiving or rescheduled to receive treatment in the neoadjuvant, adjuvant or definitive setting for curative intent. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
  • Current cancer patient at PeaceHealth (Southwest Medical Center or St. Joes)
  • Not current Medicaid enrollee
  • Not enrolled in hospice
  • Screens positive for financial fragility

Treatment and study plan

Electronic Health Record Review

Other

Ancillary studies

interview

Other

Ancillary studies

SUPPORT

Other

Receive $1000 preloaded cash card

Other names: Supportive - procedure intent

Survey Administration

Other

Ancillary studies

Primary outcomes

  1. Participant enrollment

    Time frame: Up to 1 year

    Feasibility will be measured by participant enrollment (percent enrolled versus [vs.] approached). The study will be considered feasible to implement if 60% or more of approached patients enroll.

  2. Time to accrue 20 patients

    Time frame: Up to 1 year

    Feasibility will be measured by the time in months to accrue 20 patients. The study will be considered feasible if accrual is reached by 6 months.

  3. Dropout rate

    Time frame: Up to 1 year

    Feasibility will be measured by dropout during study period. The study will be considered feasible to implement if less than 20% of patients drop out. Will be able to estimate a drop-out rate of 20% to within a 95% confidence interval of +/- 18%.

  4. Survey completion rate

    Time frame: Up to 1 year

    Feasibility will be measure by rates of survey completion. The study will be considered feasible to implement if survey completion is 90% or greater.

Secondary outcomes

  1. Financial hardship

    Time frame: Baseline, 3 and 6- months post randomization

    Will assess whether patient self-reports one or more of the following: new debt (relative to baseline), income decline of 20% or more, loans from family/friends to pay for cancer treatment, selling/refinancing primary home, >= 2 months missed rent or mortgage payments, evictions. May adjust either the methods for assessing financial hardship (e.g. using credit reports rather than surveys) or the endpoint itself based on observed survey completion rate and incidence of each endpoint.

  2. Treatment nonadherence

    Time frame: Baseline, 3 and 6- months post randomization

    Will assess whether patient self reports they did or did not skip medication doses or refuse/decline recommended therapy due to cost concerns. Evidence of treatment completion vs. missed treatments/appointments using data from electronic medical record captured by research assistant.

  3. Unplanned emergency department (ED)/hospital admissions

    Time frame: Baseline, 3 and 6- months post randomization

    All instances of ED visits and hospital stays (including reason for visit) will be abstracted from patients' medical records. The study team will categorize visits as anticipated (for chemotherapy or planned procedure) vs. unanticipated (complication or treatment side effect).

  4. Food and housing insecurity

    Time frame: Baseline, 3 and 6- months post randomization

    Will be assessed using items 1 through 4 of the 10-item Health-Related Social Needs Screening Tool from Centers for Medicare and Medicaid Services.

  5. Quality of life

    Time frame: Baseline, 3 and 6- months post randomization

    Will be assessed using the composite score from the European Quality of Life Five Dimension Index (scored 0-100). A 6-point score change is considered clinically meaningful in United States cancer populations.

Study contacts

Contact information is provided by the study sponsor or research team.

Ari Bell-Brown

CONTACT

[email protected]

206-667-7624

Sponsors and collaborators

Lead sponsor

Fred Hutchinson Cancer Center

Other

Collaborators

  • National Cancer Institute (NCI)
  • Oregon Health and Science University
  • SWOG Cancer Research Network

Registry information

Official study title

Preventing Financial Adversity Among Early-Stage Cancer Patients Through Unrestricted Cash (PAYMENT) Pilot Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 13, 2025
Registry last updated
Jul 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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