There is growing concern in Australia about patient out of pocket expenses and the contribution this makes to financial toxicity (Currow & Aranda 2016). These concerns arise in the context of an equity gap, with poorer Australians having a 30% higher age-standardised mortality from cancer than wealthy Australians. Our work in this area suggests some patients may forgo treatments because of financial toxicity and there is compelling evidence from the Asian region that financial toxicity is a predictor of likelihood of death by the end of the first year after diagnosis (. Concerns about out-of-pocket costs range from widening gaps between fees and insurance cover, bill shock for unexpected items such as surgical assistants and anaesthetists to shadow billing where excessive fees are hidden from insurers by being separated out as a booking fee. There is also growing concern around implied links between fees charged, clinician skill and patient outcomes with little or no evidence to support such claims. A recent audit from the College of Surgeons and Medibank Private, quickly removed from the website, showed that fees charged for prostatectomy relate more to capacity to pay than to the costs of the procedure. While the issue of out-of-pocket costs has traditionally arisen from surgical procedures, there is a growing problem with increased private provision of both radiotherapy and chemotherapy. For patients the matter is compounded by current approaches to informed financial consent which only require the doctor to disclose their fees but not to discuss other associated fees such as anaesthetist and pathology. While a problem in all conditions, people with cancer face these issues over months to years, across multiple treatment modalities and often in the context of reduced income. To address this issue Cancer Council Australia has collaborated with Breast Cancer Network Australia, Prostate Cancer Foundation Australia and Canteen to develop a voluntary standard of informed which seeks to encourage doctors and other private providers to take a more active approach to preparing patients for the out-of-pocket costs associated with cancer and its treatment. The standard describes expectations for both individual clinicians and the settings in which they work in helping patients to navigate the financial implications of their diagnosis. Early indications are that doctors in some of the most problematic areas, such as prostate cancer surgery, are willing to adopt the standard. This presentation will explore these issues and introduce the draft standard to encourage delegates to engage with this important issue.