Certain patients with hematologic malignancies may be at greater risk for financial toxicity, according to a recent Australian study.
Among patients seeking care through a publicly funded healthcare system, those who were of working age, those without private health insurances, and those that have been forced to retire early or were unemployed because of their diagnosis were more likely to experience financial toxicity.
“Out of pocket expenses constitute a significant contributor to financial toxicity and health-related debt, and even bankruptcy,” study authors wrote. “Most direct healthcare and hospital-related expenses in Australia are covered entirely or heavily subsidized by the Medicare Benefits Scheme. Nevertheless, out of pocket expenses borne by Australian patients were from medications, consultation fees and travel costs.”
The study surveyed 113 patients with leukemia, lymphoma, or multiple myeloma from two major metropolitan health services in Melbourne. The survey included a 12-item patient-reported outcome measure (COST) that included questions on satisfaction with finances and incomes, expenses and the ability to meet them, and level of control concerning finances and cancer care.
In all, 42% of participants experienced some level of financial toxicity. Of the participants, 37% reported that they were employed in some capacity and 26% reported that they were unemployed or forced to retire because of their diagnosis.
Most participants (71%) said they had used other means to cope financially including some or all of their savings (47%), borrowing money from friends or family (16%), or using credit card to cover costs (12%).
About one in five participants had accumulated debt, which ranged from $350 to $40,000.
A multivariate analysis showed that age older than 65 (P=0.007), higher income (P=.008), and not being forced into unemployment or retirement (P<.0.001) were significantly associated with less financial toxicity. Not holding private health insurance was independently associated with worse COST scores.
“This study represents the first investigation of financial toxicity in haematology patients in Australia, who represent a particularly vulnerable group of individuals due to the often intensive and lengthy treatments that markedly impact everyday life,” the researchers wrote. “Further efforts are needed to unravel the complexity behind the observed financial burden to mitigate this burden by earlier intervention and to begin advocating meaningfully for patients.”
