Blog Editor’s Note: Molly MacDonald is the founder and CEO of Pink Fund, a nonprofit organization that provides 90-day nonmedical cost-of-living expenses to breast cancer patients in active treatment. In honor of Breast Cancer Awareness Month, we sat down with Molly to discuss her motivation for starting Pink Fund, the impact of financial toxicity, and why it’s so crucial to help patients tackle “the other side of the fight.”
TailorMed: Tell us about your own breast cancer journey and the financial impact of your diagnosis.
Molly MacDonald: I was diagnosed in 2005. I had just joined a new company and I got the news during a business trip. My annual mammogram had come back suspicious, and the biopsy was positive for the earliest stage of breast cancer.
While that early-stage disease was not likely to take my life, it took my livelihood. I had already been through a financially devastating divorce, and I was the breadwinner for my five children and myself. I wasn’t yet eligible for health insurance through my new company, so I had a COBRA premium of $1,300 per month. I didn’t qualify for Medicaid because it was predicated on my previous year’s income.
I had two surgeries and six weeks of radiation. Within a few months, I couldn’t make the house payments. My mother rescued the house, so we wouldn’t be homeless, but we were not doing well. I was facing utility shutoff. I found myself in line for food at a church pantry.
TailorMed: How did your experience motivate you to create Pink Fund?
MM: The real “aha moment” was when I listened to other women in treatment. We were all experiencing “financial toxicity,” eight years before Drs. Yousuf Zafar and Amy Abernethy coined the term.
These women were talking about putting their houses on the market, liquidating their IRAs, and not sending their kids back to college. Their treatment protocols were going outside of their FMLA benefits, so they were at risk of losing their jobs. At that point, they were saying, “We’re stopping treatment and going back to work.” They also talked about their mental anguish.
I went home and told my husband, “Somebody needs to address this problem. We should start a nonprofit.” I had limited experience with nonprofits as a volunteer, but I just believed I could do it. Today, Pink Fund has delivered about $6.3 million in bill payments.
TailorMed: Having watched the powerful video on your website, we were struck by this staggering figure: “41% of patients alter or skip treatment due to the financial hardships of breast cancer.” How are the nonmedical grants provided by Pink Fund helping to change these statistics?
MM: I use the analogy of playing Jenga. When you get a cancer diagnosis, the foundation of your life shifts. One of those Jenga blocks is removed and you immediately lose stability. Then you find out that your health insurance policy has a high deductible—that’s another block pulled out. Then your doctor tells you that you may not be able to work for a few days after treatment. And then you have copays. Now, the Jenga tower has lots of holes and pressure on the top.
Imagine putting scaffolding around the tower—that’s what we do at Pink Fund. We’re not solving the problem of financial toxicity, but we’re helping to stabilize the families.
TailorMed: There are several moving testimonials on your website about how Pink Fund has helped beneficiaries overcome financial toxicity. Are there particular stories or anecdotes that you’ve found most inspiring?
MM: One of the messages we’ve heard is, “I’m crying happy tears for the first time in months.” Another one that stood out is, “I’m ready to schedule my chemo.” The patient had decided not to have chemotherapy because she couldn’t afford to miss work. What changed her mind was that Pink Fund was making her house payments for three months.
We had one note where a patient said that because we helped her, she could buy strawberries. Strawberries were a simple joy for her, but when she couldn’t afford food, they became an indulgence.
TailorMed: What are the greatest rewards and the greatest challenges of your work leading Pink Fund?
MM: The rewards are the testimonials. People come to us in a dark place, and we help lead them toward the light. When we get a supporter who understands, through empathy, what this might be like for a patient—that’s another reward.
The challenges are that we are scaling, so we need more resources and support. We also want to streamline and digitize our grant application process, which is still in paper form. Our goal is to remove all barriers and make it easier for patients to apply.
TailorMed: We’re proud to partner with organizations like yours that offer a lifeline to patients experiencing financial hardship. How did you first learn about TailorMed and its mission to “move mountains for patients”?
MM: I learned about TailorMed at a conference. What TailorMed provides is a wraparound, holistic approach to the problem of affordability. And that’s key, because without this type of platform, patients and their advocates—whether it’s a family member or somebody in the provider setting—are going down multiple rabbit holes, trying to cobble together a solution.
TailorMed: How do you think financial navigation, with the support of technology, can help breast cancer patients—and their care teams—better access vital resources such as the grants you provide?
MM: TailorMed’s technology gives healthcare organizations the ability to identify those who may be experiencing financial challenges, without making assumptions about how somebody presents.
The other piece is that people who have financial challenges are embarrassed to talk about it. It’s important for care teams to start a conversation by saying, “We know cancer treatment is expensive and we just want to make you aware of what your insurance will cover and what might be available to you if you find yourself in need.”
That’s another reason I love TailorMed’s system—it allows patients to plan. Knowledge is power.
TailorMed: You describe the financial burden of breast cancer as “the other part of the fight.” As we recognize Breast Cancer Awareness Month, what do you wish more healthcare organizations, patients, and society at large understood about this “other part”? What can we do to help address this challenge?
MM: We collaborated on a study authored by Dr. Reshma Jagsi at the University of Michigan. Dr. Jagsi wrote the following: “To cure a patient’s disease at the cost of financial ruin is to fall short of the physician’s duty to serve. Failure to recognize and mitigate a patient’s financial distress is no longer acceptable.” That says it.
We need more education around the decisions many patients are facing: Chemo or car payment? Medicine or mortgage? Radiation or rent? Life or life savings? And it’s not just in oncology.
At Pink Fund, we believe that no patient should have to make these impossible choices.