Financial toxicity

Financial toxicity describes the negative impact medical expenses can have on patients in terms of their health related quality of life,[1] leading to negative mental and physical effects as well as, in some cases, bankruptcy.

Background

The term financial toxicity was used in a 2009 article about the cancer drug industry "as a side effect of cancer drug treatment, along with nausea and hair loss".[2]

The cost of medical treatment has become a major complication of treatment in the United States, leading to suffering comparable to physical suffering and damaging a person´s ability to recover from their illness, according to a 2013 study published in The Oncologist journal.[3] Patients can forgo treatments or opt for less-costly treatments, which can have a negative impact on their health.[4]

Prevalence

In a study from Oregon almost 20% of older adults with advanced cancer experienced financial toxicity.[5] This was assessed using 3 simple questions: "At any time in the past 3 months have you taken less medication than was prescribed for you because of the cost?" (delayed medications); the second question was, "When you think about the amount of income that you have available in a typical month, is there enough for your food and housing costs?" (income available) and the third question was, "When you think about the amount of income that you have available in a typical month, is it enough for things you really need like clothing, medicine, repairs to the home or transportation” (enough income).[5]

Risk factors

As of 2020, preexisting debt, prediagnosis conditions, type of employment like hourly versus salaried and asset levels are "areas in need of further study" according to the National Cancer Institute.[6]

Interventions

Since 2009, the American Society of Clinical Oncology recommends in a guidance that health care professionals talk to patients about costs.[7] Providing financial information, counseling of the patient with "financial navigators" have been suggested. However cancer treatment cost information is intransparent.[6]

See also

References
  1. Khera R, Valero-Elizondo J, Nasir K (October 2020). "Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions". Journal of the American Heart Association. 9 (19): e017793. doi:10.1161/JAHA.120.017793. PMID 32924728.
  2. Pollack, Andrew (2009-09-02). "For Profit, Industry Seeks Cancer Drugs (Published 2009)". The New York Times. ISSN 0362-4331. Retrieved 2021-01-13.
  3. Yousuf Zafar, Jeffrey M. Peppercorn, Deborah Schrag, Donald H. Taylor, Amy M. Goetzinger, Xiaoyin Zhong, Amy P. Abernethy.S. The Financial Toxicity of Cancer Treatment: A Pilot Study Assessing Out-of-Pocket Expenses and the Insured Cancer Patient’s Experience. The Oncologist 2013;18:381–390
  4. Financial Toxicity’s Effects on the Quality of Cancer Care: A Conversation with Dr. Yousuf Zafar
  5. Arastu, Asad; Patel, Arpan; Mohile, Supriya Gupta; Ciminelli, Joseph; Kaushik, Ramya; Wells, Megan; Culakova, Eva; Lei, Lianlian; Xu, Huiwen; Dougherty, David W.; Mohamed, Mostafa R. (2020-12-07). "Assessment of Financial Toxicity Among Older Adults With Advanced Cancer". JAMA Network Open. 3 (12): e2025810. doi:10.1001/jamanetworkopen.2020.25810. ISSN 2574-3805.
  6. "Financial Toxicity and Cancer Treatment–Health Professional Version - National Cancer Institute". www.cancer.gov. 2016-08-26. Retrieved 2021-01-13.
  7. Meropol, Neal J.; Schrag, Deborah; Smith, Thomas J.; Mulvey, Therese M.; Langdon, Robert M.; Blum, Diane; Ubel, Peter A.; Schnipper, Lowell E. (2009-08-10). "American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care". Journal of Clinical Oncology. pp. 3868–3874. doi:10.1200/JCO.2009.23.1183. Retrieved 2021-01-13.
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