Financial toxicity in patients with lung cancer: a scoping review protocol

Fu, Liang; Zhuang, Minling; Luo, Chengcan; Zhu, Ruiyun; Wu, Bei; Xu, Wenxia; Xu, Bo; Xu, Ruiyan; Ye, Xianghong

doi:10.1136/bmjopen-2021-057801

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Financial toxicity is one of the most common concerns for patients with cancer including lung cancer (43). Similar to previous studies (44,45), some of our participants experienced distress related to medical insurance status, out-of-pocket costs, and treatment expenses that negatively affected their QOL.…”

Section: Discussionsupporting

confidence: 78%

Social determinants of health and lung cancer surgery: a qualitative study

Teteh,

Ferrell,

Okunowo

et al. 2023

Front. Public Health

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IntroductionSocial determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients.MethodsThirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently confirmed by a second group of independent investigators. Themes were finalized, and discrepancies were reviewed and resolved.ResultsSix themes, each with several subthemes, emerged. Overall, most participants were knowledgeable about the concept of SDOH and perceived that provider awareness of SDOH information was important for the delivery of comprehensive care in surgery. Some participants described financial challenges during treatment that were exacerbated by their cancer diagnosis and resulted in stress and poor QOL. The perceived impact of education varied and included its importance in navigating the healthcare system, decision-making on health behaviors, and more economic mobility opportunities. Some participants experienced barriers to accessing healthcare due to insurance coverage, travel burden, and the fear of losing quality insurance coverage due to retirement. Neighborhood and built environment factors such as safety, air quality, access to green space, and other environmental factors were perceived as important to QOL. Social support through families/friends and spiritual/religious communities was perceived as important to postoperative recovery.DiscussionAmong lung cancer surgery patients, SDOH factors can impact QOL and the patient’s survivorship journey. Importantly, SDOH should be assessed routinely to identify patients with unmet needs across the five domains. SDOH-driven interventions are needed to address these unmet needs and to improve the QOL and quality of care for lung cancer surgery patients.

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Section: Discussionsupporting

confidence: 78%

Social determinants of health and lung cancer surgery: a qualitative study

Teteh,

Ferrell,

Okunowo

et al. 2023

Front. Public Health

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“… 3 Excess financial burden among patients with cancer is increasingly common and can lead to psychological distress 4 and financial toxicity including medical debt, foregoing or delaying health care, and bankruptcy in extreme cases. 5 6 While these direct and indirect costs of cancer care have been studied in other cancers, 7 8 they have not been well described in HCC.…”

Section: Introductionmentioning

confidence: 99%

Financial burden in a US cohort of patients with HCC

Desai,

Jiang,

VanWagner

et al. 2024

Hepatology Communications

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Background: High financial burden for patients has been reported for multiple types of cancer, but there are limited data in those with HCC. We aimed to describe the financial burden for patients diagnosed with HCC and identify correlates of high financial burden. Methods: We used the IQVIA PharMetrics Plus for Academics database to identify commercially insured patients diagnosed with HCC between 2006 and 2021. Patient financial liability was defined as the difference between allowed and paid amounts from adjudicated insurance claims. We reported total and HCC-related financial liabilities (i.e., cost for HCC-related claims), with high total financial liability defined as ≥$3000 annually and high HCC–related financial liability as ≥$1000 annually. We used multivariable logistic regression modeling to identify factors associated with high total and HCC-related financial liability. Results: Among 11,609 patients with HCC, the median total financial liability during the year after HCC diagnosis was $2955 (Q1–Q3: $972–$6293). Nearly half (45%) of patients experienced high total financial liability, with the greatest liability incurred in the 3-month period immediately following HCC diagnosis. Older age, increased comorbidity, and cirrhosis-related complications were associated with higher total patient liability. Patient liability also varied by type of HCC treatment, with systemic therapy and liver transplantation having the highest financial liability in multivariable analysis. However, only 66.7% of the patients experienced HCC-related liability. Conclusions: Patients with HCC experience significant financial liability underscoring a need for price transparency as well as financial counseling in this population.

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