Cancer and COVID-19: economic impact on households in Southeast Asia

Abstract

The ongoing COVID-19 pandemic may worsen the existing financial vulnerabilities of cancer survivors who may be experiencing a double financial hit, both from cancer-induced financial toxicity as well as economic strains arising from loss of income and prolonged unemployment following the pandemic. The impact of the pandemic is likely to be more pronounced on cancer survivors living in resource-limited settings, such as in Southeast Asia. As health care systems in the region try to streamline resources and accommodate the influx of patients from COVID-19, many in the cancer community have experienced severe disruptions in their care. The delays and disruption of timely access to cancer care could lead to patients presenting with worsened conditions and at more advanced cancer stages in which treatment options tended to be costlier. Similar to countries around the world, the various forms of movement restrictions that were enforced have aggravated the rates of unemployment, loss of wages and the limited access to support from family or friends around Southeast Asia. The economic impact of COVID-19 hits even harder on the large proportion of the population in the region that works in the informal sector, who are often one paycheque or one episode of illness away from financial catastrophe. More worryingly, the lack of a robust social security system in many Southeast Asian countries, especially in terms of income protection, could ultimately force many cancer survivors to choose between paying for their treatments, or to forego treatments, and feed their families. Early identification of cancer patients experiencing financial toxicity following the pandemic will enable timely and appropriate interventions to be undertaken by various stakeholders, potentially averting a cascade of other economic fallouts that may last for years after cancer treatment.

Economic impact of avoidable cancer deaths caused by diagnostic delay during the COVID-19 pandemic: A national population-based modelling study in England, UK

“…A 3-month delay is predicted to result in $12 million AUD excess health care costs over 5 years, and a 6-month delay $46 million AUD. Two other international studies have highlighted the increased risk of financial toxicity that cancer patients face during the COVID-19 pandemic due to rising unemployment levels and economic recession, meaning patients have to increasingly pay out of pocket due to loss of employment-based insurance or may forgo lifesaving treatments to support their families financially [25,26].…”

Risk factors and clinical outcomes of systemic cancer treatment delays in Filipino patients with solid tumor malignancy during the COVID‐19 pandemic: A single tertiary center study

“…During the Covid-19 pandemic, factors might delay treatment can be grouped in two According to a recent report on the impact of Covid-19 and national income, there was at least a 10% decline in income across the entire income distribution and a record-high unemployment rate of 18%, meaning that about 7.3 million Filipinos had lost their jobs. 23 Most of the included patients in this study were from the mid-to high-income sector, which may signify that they were also vulnerable to treatment delays due to financial losses.…”

Economic distress, financial toxicity, and medical cost‐coping in young adult cancer survivors during the COVID‐19 pandemic: Findings from an online sample

“… 17 Cancer survivors with transient or temporary employment, which is more likely in young adulthood, have been reported to be at higher risk for the negative economic effects of COVID‐19. 18 , 19…”

“…17 Cancer survivors with transient or temporary employment, which is more likely in young adulthood, have been reported to be at higher risk for the negative economic effects of COVID-19. 18,19 Little is known about how the pandemic has specifically affected the financial situations of YA cancer survivors, a population already susceptible to financial hardship. To fill this gap, this study aimed to 1) describe cancer-related financial toxicity, pandemic-related negative economic events, and medical-related cost-coping behaviors in a national sample of YA cancer survivors during COVID-19; 2) determine the relationships among financial toxicity, pandemic-related negative economic events, and cost-coping behaviors; and 3) identify associations with cost-coping behaviors in multivariate analyses.…”