PURPOSE: : Because of the escalating cost of cancer care coupled with high insurance deductibles, premiums, and uninsured populations, patients with cancer are affected by treatment-related financial harm, known as financial toxicity. The purpose of this study was to describe individuals reporting financial toxicity and to identify rates of and reasons for affordability-related treatment noncompliance. METHODS: : From May 2010 to November 2015, adult patients (age ≥ 18 years) with cancer were identified from a Health Registry/Cancer Survivorship Cohort. Financial toxicity was defined as agreement with the phrase "You have to pay for more medical care than you can afford" from the Patient Satisfaction Questionnaire-18. Logistic regression and Fisher exact tests were used to compare groups. RESULTS: : Of 1,988 participants, 524 (26%) reported financial toxicity. Patients reporting financial toxicity were more likely age 65 years or younger, female, nonwhite, non-English speaking, not married, less educated, and to have received a diagnosis more recently (all P < .001). Participants with financial toxicity were more likely to report noncompliance with medication, owing to inability to afford prescription drugs (relative risk [RR], 3.55; 95% CI, 2.53 to 4.98), and reported forgoing mental health care (RR, 3.89; 95% CI, 2.04 to 7.45), doctor's visits (RR, 2.98; 95% CI, 1.97 to 4.51), and medical tests (RR, 2.54; 95% CI, 1.49 to 4.34). The most endorsed reasons for delayed care were not having insurance coverage and being unable to afford household expenses. CONCLUSION: : More than 25% of adults with cancer reported financial toxicity that was associated with an increased risk for medical noncompliance. Financial toxicity remains a major issue in cancer care, and efforts are needed to ensure patients experiencing high levels of financial toxicity are able to access recommended care.
PURPOSE: : Because of the escalating cost of cancer care coupled with high insurance deductibles, premiums, and uninsured populations, patients with cancer are affected by treatment-related financial harm, known as financial toxicity. The purpose of this study was to describe individuals reporting financial toxicity and to identify rates of and reasons for affordability-related treatment noncompliance. METHODS: : From May 2010 to November 2015, adult patients (age ≥ 18 years) with cancer were identified from a Health Registry/Cancer Survivorship Cohort. Financial toxicity was defined as agreement with the phrase "You have to pay for more medical care than you can afford" from the Patient Satisfaction Questionnaire-18. Logistic regression and Fisher exact tests were used to compare groups. RESULTS: : Of 1,988 participants, 524 (26%) reported financial toxicity. Patients reporting financial toxicity were more likely age 65 years or younger, female, nonwhite, non-English speaking, not married, less educated, and to have received a diagnosis more recently (all P < .001). Participants with financial toxicity were more likely to report noncompliance with medication, owing to inability to afford prescription drugs (relative risk [RR], 3.55; 95% CI, 2.53 to 4.98), and reported forgoing mental health care (RR, 3.89; 95% CI, 2.04 to 7.45), doctor's visits (RR, 2.98; 95% CI, 1.97 to 4.51), and medical tests (RR, 2.54; 95% CI, 1.49 to 4.34). The most endorsed reasons for delayed care were not having insurance coverage and being unable to afford household expenses. CONCLUSION: : More than 25% of adults with cancer reported financial toxicity that was associated with an increased risk for medical noncompliance. Financial toxicity remains a major issue in cancer care, and efforts are needed to ensure patients experiencing high levels of financial toxicity are able to access recommended care.
Authors: Grant R Williams; Mustafa Al-Obaidi; Chen Dai; Nabiel Mir; Sai Alekha Challa; Michael Daniel; Harita Patel; Brett Barlow; Crystal Young-Smith; Olumide Gbolahan; Ravi Paluri; Smita Bhatia; Smith Giri Journal: Cancer Date: 2020-09-04 Impact factor: 6.860
Authors: Nabiel Mir; Paul MacLennan; Mustafa Al-Obaidi; Donna Murdaugh; Kelly M Kenzik; Andrew McDonald; Noha Sharafeldin; Crystal Young-Smith; Ravi Paluri; Olumide Gbolahan; Lakshmin Nandagopal; Smita Bhatia; Grant R Williams Journal: J Geriatr Oncol Date: 2020-03-13 Impact factor: 3.599
Authors: Heydon K Kaddas; Samantha T Pannier; Karely Mann; Austin R Waters; Sara Salmon; Tomoko Tsukamoto; Echo L Warner; Brynn Fowler; Mark A Lewis; Douglas B Fair; Anne C Kirchhoff Journal: J Adolesc Young Adult Oncol Date: 2019-09-16 Impact factor: 2.223
Authors: Neil T Mason; Jason M Burkett; Ryan S Nelson; Julio M Pow-Sang; Robert A Gatenby; Timothy Kubal; John W Peabody; G Douglas Letson; Howard L McLeod; Jingsong Zhang Journal: Am Health Drug Benefits Date: 2021-03
Authors: Megan E V Caram; Mary K Oerline; Stacie Dusetzina; Lindsey A Herrel; Parth K Modi; Samuel R Kaufman; Ted A Skolarus; Brent K Hollenbeck; Vahakn Shahinian Journal: Cancer Date: 2020-09-14 Impact factor: 6.860