Meera Ragavan – Fellow 2022
I am a current second year oncology fellow at UCSF. I’m thrilled to be joining the Costs of Care team and follow in the footsteps of 4 incredible affordability researchers whose work has been an inspiration to my own.
Throughout my clinical training, I have been motivated to find ways we can promote better care at a lower cost. As an oncology fellow, I have been awe-inspired by the years of scientific discovery that has led to incredible advancements in cancer care and improved outcomes over the past few decades. Matching my awe, however, has been frustration with the fact that up to a third of cancer patients may be at risk for financial insolvency due to treatment-related costs. Many patients cannot afford life-saving drugs or do so at a substantial cost to their well-being and quality of life. Our patients are already navigating complex decision-making, often with a life-limiting disease, and I feel passionately that the pace of scientific discovery and precision oncology must be matched by changes in cancer care delivery to ensure we are providing high-value, equitable, and affordable care.
In my prior work studying financial toxicity, I designed a survey1 to evaluate oncologists’ perspectives and practices around discussing cost with patients, as well as helped conduct a multi-site, patient-facing study to identify and compare predictors of financial distress across three disparate healthcare delivery systems.2 In the former study, we found that most oncologists agreed cost of treatment should be incorporated into treatment decisions, but felt they lack the knowledge and skills to do so. My career ambition is to help fill this gap by developing simple and scalable workflows to help providers, clinics, and delivery systems mitigate financial toxicity for our patients.
Under the mentorship of the Costs of Care team, I plan to study the impact that out of pocket costs and receipt of financial assistance have on clinical outcomes for patients taking oral cancer drugs (oncolytics). I hope to use the findings to develop an intervention with multi-disciplinary input to ensure all patients have equitable access to existing financial resources.
The affordability of oral oncolytics is an urgent issue, as an increasing number of these medications are approved by the FDA and as the overall cost of these medications continues to rise. Patient outcomes have fortunately improved across many disease types with the advent of these drugs. It will be increasingly important, however, to identify resources for financial support and mechanisms for cost control, as many patients may take these medications for years.
I received my M.D degree from Stanford University and stayed at Stanford to complete my training in Internal Medicine. I also hold a Master’s in Public Health with a focus in health policy from the Harvard T.H Chan School of Public Health. I am a native of Northern California and enjoy hiking, cooking, and chasing around my one year old daughter.