Guaranteed Income for Cancer Patients

(GIFT Trial)

Not currently recruiting at 2 trial locations

Overseen By Meredith Doherty, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Meredith Doherty

Must be taking: Chemotherapy, Immunotherapy

Disqualifiers: Hospice eligible, Language barrier

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 9

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether providing advanced cancer patients with $1,000 a month for a year can improve their quality of life and potentially their survival. The researchers aim to determine if this extra income, known as Guaranteed Income (also referred to as Basic Income, Universal Basic Income, or Unconditional Cash Payments), can reduce financial stress and enhance overall well-being. Participants will either receive this monthly payment or receive advice on managing financial issues. Individuals diagnosed with advanced cancer (Stage 3 or 4), undergoing treatment such as chemotherapy or immunotherapy, and residing in Pennsylvania with Medicaid may be eligible to join. As an unphased trial, this study offers a unique opportunity to explore innovative ways to enhance the quality of life for cancer patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on financial support rather than medication changes.

What prior data suggests that this guaranteed income is safe for cancer patients?

Research has shown that providing a guaranteed monthly income can be safe and beneficial for health. In past studies, giving $1000 each month to low-income families in financial distress improved their health. Another study found that guaranteed income reduced stress and made it easier for families to afford food, although it didn't significantly change physical health.

For this type of support, safety concerns are minimal. Since the intervention involves giving money, it lacks the side effects associated with medications. No reports of negative effects from receiving extra income exist, and the main benefits have been financial and stress-related.

In summary, receiving a guaranteed income is generally safe, with no major safety issues reported. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Guaranteed Income program for cancer patients because it offers a novel approach to addressing financial stress, a common issue that current medical treatments do not typically tackle. Unlike traditional therapies that focus directly on the cancer itself, this program provides patients with a monthly income of $1,000 for a year, aiming to alleviate financial toxicity and improve overall well-being. By reducing financial stress, the program could potentially enhance patients' quality of life and their ability to adhere to medical treatments, offering a holistic approach that current medical options do not provide.

What evidence suggests that guaranteed income could improve cancer outcomes?

This trial will compare a guaranteed income intervention with a control condition for cancer patients. Participants in the intervention arm will receive $1000 a month for 12 months. Studies have shown that providing a guaranteed income, such as $1000 a month, can improve health in low-income groups. Research suggests that these cash payments can help reduce financial stress, a significant issue for cancer patients. Some studies have found that this additional income enables people to purchase healthier food, exercise more, and improve their overall health care. While specific data on cancer outcomes is still being collected, early results suggest that reducing financial stress can enhance quality of life and possibly improve survival rates. The concept is promising, but more research is needed to confirm these benefits specifically for cancer patients. ^{1 6 7 8 9}

Who Is on the Research Team?

Meredith Doherty

Principal Investigator

University of Pennsylvania

Are You a Good Fit for This Trial?

This trial is for advanced cancer patients experiencing financial hardship. Participants will receive $1000 monthly for a year and complete surveys every 3 months. Some may also be interviewed about their finances.

Inclusion Criteria

1. Age = 18 or older

2. Newly diagnosed or recurrent advanced cancer (Stage 3 or 4)

3. Receiving chemotherapy or immunotherapy (with or without radiation) at one of the recruitment sites

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive $1000/month for 12 months

12 months

Surveys at baseline, 3, 6, 9, and 12 months

Follow-up

Participants are monitored for financial toxicity, quality of life, and treatment adherence

12 months

Surveys at 6 and 12 months

Long-term Follow-up

Social security records used to explore mortality effects

5 years

What Are the Treatments Tested in This Trial?

Interventions

• Guaranteed Income

Trial Overview The study tests if an extra $1000 per month can reduce financial stress, improve quality of life, and potentially enhance survival outcomes in advanced cancer patients.

How Is the Trial Designed?

Group I: Intervention arm Experimental Treatment 1 Intervention

Participants assigned to the intervention arm receive $1000/month for 12 months

Group II: Control arm Experimental Treatment 1 Intervention

Participants assigned to the control arm receive information on financial toxicity and the contact information for their social workers and financial counselors

Guaranteed Income is already approved in United States for the following indications:

Approved in United States as Guaranteed Income for:

• Homelessness prevention
• Housing stability support
• Financial assistance for low-income families

Who Is Running the Clinical Trial?

Meredith Doherty

Lead Sponsor

Trials

1

Recruited

250+

Meredith Doherty, PhD, LCSW

Lead Sponsor

Mathematica Policy Research, Inc.

Collaborator

Trials

68

Recruited

31,130,000+

Published Research Related to This Trial

A welfare rights advice intervention for cancer patients and their carers significantly increased income, with a 96% success rate in benefit claims, resulting in a median weekly income increase of £70.30.

The intervention not only alleviated financial stress but also improved overall well-being and quality of life by helping patients manage costs associated with cancer, highlighting the importance of integrating financial support services in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing the financial consequences of cancer: qualitative evaluation of a welfare rights advice service. Moffatt, S., Noble, E., White, M.[2021]

In France, cancer patients receive full reimbursement for medical and pharmaceutical expenses, along with income support during their treatment, which helps alleviate financial burdens during recovery.

New laws have improved job security for cancer patients, allowing civil servants to take up to 5 years off for treatment without dismissal, although the return-to-work rates are lower for poorly qualified workers due to economic challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Rehabilitation and social reintegration of cancer patients]. Schraub, S.[2009]

Mothers of children with cancer initially had higher total incomes compared to reference mothers, but their income dropped significantly after the diagnosis, leading to lower long-term earnings as social benefits decreased over time.

Social benefits provided crucial financial support during the cancer diagnosis period, but the long-term financial impact on mothers, especially in single-parent households, raises concerns about their future career and pension outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trajectories of income and social benefits for mothers and fathers of children with cancer: A national cohort study in Sweden. Hiyoshi, A., Montgomery, S., Bottai, M., et al.[2019]

In a study of 1,294 newly diagnosed cancer patients in Malaysia, 51% experienced financial catastrophe within a year, highlighting significant financial burdens despite universal health coverage.

Factors such as low-income status, type of hospital, and lack of health insurance were strong predictors of financial toxicity, with nonmedical costs significantly contributing to the financial hardships faced by patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial Toxicity After Cancer in a Setting With Universal Health Coverage: A Call for Urgent Action. Bhoo-Pathy, N., Ng, CW., Lim, GC., et al.[2020]

Multi-disciplinary stepped psycho-social care significantly reduces financial problems at discharge for cancer patients who initially reported such issues, with an odds ratio of 0.2, indicating a strong positive effect.

However, the stepped care approach did not show a significant impact on the return-to-work rates for patients under 65 years old, suggesting that while it helps with financial issues, it may not directly improve employment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial. Singer, S., Roick, J., Meixensberger, J., et al.[2019]

About 60% of cancer patients survive for more than five years, but many experience reduced performance and significant income loss, averaging 26% in Germany, which can lead to socioeconomic challenges.

The concept of 'financial toxicity' arises from the financial burdens of cancer treatment, impacting patients' quality of life and potentially their disease prognosis, highlighting the need for support measures, especially for young adults with cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Socioeconomic risks for people with cancer-possible consequences and assistance]. Seifart, U.[2022]

The Guaranteed Income and Financial Treatment (GIFT) Trial will evaluate the impact of a 12-month unconditional cash transfer of $1,000 per month on financial toxicity and health-related quality of life in 250 low-income cancer patients, aiming to address the financial burdens associated with cancer treatment.

This study is significant as it explores a novel intervention—unconditional cash transfers—specifically for cancer patients, which has shown positive health effects in other low-income populations but has not been previously tested in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guaranteed Income and Financial Treatment (G.I.F.T.): a 12-month, randomized controlled trial to compare the effectiveness of monthly unconditional cash transfers to treatment as usual in reducing financial toxicity in people with cancer who have low incomes. Doherty, M., Heintz, J., Leader, A., et al.[2023]

A study of 664 female breast cancer patients in China revealed a median financial toxicity score of 21, indicating significant financial strain related to healthcare costs, particularly for those with stage IV cancer or lower household income.

Nearly half of the patients reported using coping strategies such as delaying treatment or not following medical advice, highlighting the need for oncologists and policymakers to address financial burdens to improve patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial toxicity in female patients with breast cancer: a national cross-sectional study in China. Liu, M., Hu, L., Han, X., et al.[2022]

In a study of 210 breast cancer patients in a lower- to middle-income country, 81% reported significant financial toxicity, indicating a high level of financial strain due to their cancer diagnosis.

Key contributors to financial toxicity included travel costs (94%), out-of-hospital investigations (87%), and consultation fees (81), leading many patients to make daily compromises in basic needs like food and education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breast Cancer-Related Financial Toxicity in Sri Lanka: Insights From a Lower Middle-Income Country With Free Universal Public Healthcare. Ranawaka, S., Gunarathna, S., Gunasekera, S., et al.[2023]

Cancer patients, especially in rural areas of Kentucky, experience significant financial toxicity due to high care costs and limited health literacy, which complicates their ability to discuss and manage these costs effectively.

There is a critical need for dedicated financial navigators and improved systems for assessing and addressing financial barriers in cancer care, as current resources are insufficient to support patients in navigating their financial challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Availability and Accessibility of Cancer Care Delivery Approaches to Reduce Financial Toxicity of Rural and Urban Cancer Patients in Kentucky. Edward, J., Bowling, W., Chitwood, H., et al.[2023]

The NCI and NIH have allocated $50 million over 5 years to five university-based centers to enhance cancer outcomes in low-income areas through targeted research and programs.

The initiative focuses on engaging patients in cancer prevention strategies, including lifestyle changes like smoking cessation, healthy eating, and increased physical activity, to improve health in high-poverty communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anticancer Initiative Targets Areas of Poverty. [2023]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1546144024005325

Studying Guaranteed Income in Oncology: Lessons ... Described in policy circles as guaranteed or basic income, UCTs have been shown to improve a range of health outcomes in low-income populations but have not yet ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10234289/

Guaranteed Income and Financial Treatment Trial (GIFT ... The GIFT trial compares $1000/month unconditional cash transfers to usual treatment for 12 months in low-income cancer patients to reduce ...

3. aamc.org aamc.org/news/could-giving-low-income-patients-cash-improve-their-health

Could giving low-income patients cash improve their health? Some researchers at academic medical centers have launched clinical trials to study the impact of cash assistance for low-income patients on health outcomes.

4. med.stanford.edu med.stanford.edu/news/all-news/2023/06/cancer-poverty-grant.html

Stanford Medicine-led study on income supplementation ... The researchers will investigate whether recipients of the guaranteed income or earned income tax credit are able to eat better, exercise more ...

5. jdc.jefferson.edu jdc.jefferson.edu/cgi/viewcontent.cgi?article=1239&context=medoncfp

A 12-Month, Randomized Controlled Trial to Compare the Ef The GIFT trial compares monthly unconditional cash transfers to usual treatment to reduce financial toxicity in low-income cancer patients. It ...

6. hls.harvard.edu hls.harvard.edu/today/harvard-law-expert-says-prescribing-cash-to-low-income-families-improves-health-outcomes/

Prescription for cash in a crisis? - Harvard Law School Harvard Law expert Erika Hanson argues that providing direct cash supports to low-income families experiencing a medical crisis improves health outcomes.

7. withpower.com withpower.com/trial/guaranteed-income-for-cancer-patients-b10b8

Guaranteed Income for Cancer Patients (GIFT Trial) The goal of this clinical trial is to learn if providing advanced cancer patients with $1000/month for 12 months will improve cancer outcomes. The main ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11815433/

The financial toxicity of cancer: unveiling global burden ... Patients in low-income level face a substantially increased risk of CHE (AOR 5.57, 95% CI 3.86 to 7.29). Lack of health insurance increases the ...

9. nber.org nber.org/system/files/working_papers/w32711/w32711.pdf

Does Income Affect Health? Evidence from a Randomized ... A study found that a guaranteed income caused short-lived improvements in stress and food security, but no effect on physical health measures.