Financial toxicity of patients with lung cancer in China: Results from a National Survey Study

Liu, Meicen; Huang, Dengmin; Liu, Yuanli

doi:10.1002/cam4.5244

Cited by 14 publications

(12 citation statements)

References 46 publications

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“…Moreover, the average out‐of‐pocket costs for our patients exceeded those of patients diagnosed with breast ($1823), colorectal ($1193), and lung cancer ($1649) 29 . In comparison to patients receiving cancer treatment, the HS population demonstrates FT levels similar to patients with breast, lung, and colorectal cancer 30–36 . While these comparisons do not deem HS a more burdensome disease or requiring more extensive health care coverage than any malignancy, they allude to the notion that the indirect costs of HS may be greater than what is perceived by the health care system.…”

Section: Discussionmentioning

confidence: 87%

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Financial toxicity of hidradenitis suppurativa: A single‐center experience at an urban wound‐care clinic

Towfighi

Huffman

Bovill

et al. 2023

The Journal of Dermatology

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Hidradenitis suppurativa (HS), is a chronic inflammatory skin disorder that confers a substantial financial burden to patients. The aim of the current study was to assess the patient‐reported financial impact of HS. Patients presenting to a wound center between 2010 and 2021 were retrospectively reviewed. Demographics, comorbidities, and disease characteristics were collected. The financial impact of HS was assessed via the Comprehensive Score for Financial Toxicity ‐ Functional Assessment of Chronic Illness Therapy (COST‐FACIT) version 2 and investigator‐generated surveys. Of 199 patients contacted, 27.1% (n = 54) completed the survey. The majority were women (77.8%, n = 42) and had private health insurance (n = 30; 55.6%). Most patients (66.7%, n = 36) had Hurley stage III disease. Mean follow‐up was 2.3 + 2.8 years. The overall COST score was 19.7 + 12.4, indicating grade 1 financial toxicity (FT). Grade 0 FT was reported in 31.5% (n = 17) of patients, grade 1 in 37.0% (n = 20), grade 2 in 27.8% (n = 15), and grade 3 in 3.7% (n = 2). The mean self‐reported 12‐month out‐of‐pocket cost and credit scores were $2250 + 3269.24 and 674.6 + 95.3, respectively. Patients with private insurance had lower FT compared with Medicaid and Medicare (p = 0.003). Higher out‐of‐pocket costs were positively correlated with FT (p = 0.042), while higher credit scores were negatively correlated (p = 0.003). Patients with HS lesions in three or more anatomic regions reported the highest FT (p = 0.031). HS is a debilitating skin disorder that affects the livelihood of patients in a multifaceted manner. These patient‐reported outcomes highlight the impact that HS has on an individual's financial security, calling for further attention to this vulnerable population.

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Section: Discussionmentioning

confidence: 87%

“…29 In comparison to patients receiving cancer treatment, the HS population demonstrates FT levels similar to patients with breast, lung, and colorectal cancer. [30][31][32][33][34][35][36]…”

Section: Insurance and Financial Factorsmentioning

confidence: 99%

Financial toxicity of hidradenitis suppurativa: A single‐center experience at an urban wound‐care clinic

Towfighi

Huffman

Bovill

et al. 2023

The Journal of Dermatology

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“…The incidence of lung cancer has risen over the past decade, 3 increasing the physical, psychological, and economic strain on patients. Hospitalization costs constitute a significant part of the overall medical expenses for cancer in China 4–7 . This financial strain, often compounded by a loss of income, can adversely affect patients, resulting depression, and diminished sense of financial well‐being.…”

Section: Introductionmentioning

confidence: 99%

“…Hospitalization costs constitute a significant part of the overall medical expenses for cancer in China. [4][5][6][7] This financial strain, often compounded by a loss of income, can adversely affect patients, resulting depression, and diminished sense of financial well-being. Zafar et al introduced the term "financial toxicity" to describe these adverse impacts.…”

Section: Introductionmentioning

confidence: 99%

Health insurance as a moderator in the relationship between financial toxicity and medical cost‐coping behaviors: Evidence from patients with lung cancer in China

Cui,

Lv,

et al. 2024

Cancer Medicine

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ObjectiveThis study investigates the relationship between financial toxicity and medical cost‐coping behaviors (MCCB) in Chinese patients with lung cancer, with a particular focus on the moderating role of health insurance.MethodsWe surveyed 218 patients with lung cancer and assessed their Comprehensive Score for Financial Toxicity (COST) and self‐reported MCCB. Patients were categorized into Urban Employee's Basic Medical Insurance (UEBMI) group and Urban–Rural Resident Basic Medical Insurance Scheme (URRBMI) groups by their medical insurance, and matched for socioeconomic, demographic, and disease characteristics via propensity score.ResultsSignificant different characteristics were noted between UEBMI patients and URRBMI patients. Patients with UEBMI had higher COST scores but lower levels of MCCB compared to URRBMI patients in the original dataset. After data matching, multivariate logit regression analysis showed that better financial toxicity was associated with lower levels of MCCB (OR = 0.95, 95% CI: 0.92–0.99). Health insurance type did not have a direct association with cost‐coping behaviors, but an interaction was observed between health insurance type and financial toxicity. Among patients with URRBMI, better financial toxicity was associated with lower levels of cost‐coping behaviors (OR = 0.89, 95% CI: 0.83–0.95). Patients with UEBMI had a lower probability of engaging in any cost‐coping behaviors in situations of worse financial toxicity compared to patients with URRBMI.ConclusionThe findings suggest that financial toxicity is correlated with MCCB in Chinese patients with lung cancer. The type of health insurance, specifically UEBMI and URRBMI, plays a moderating role in this relationship. Understanding these dynamics is essential for developing targeted interventions and policies to mitigate financial toxicity and improve patients' management of medical costs.

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“…FT adversely affects patients' preferences for decision making, adherence toward treatment and drugs, and rehabilitation during follow-up care, resulting in a decreasing life quality [16][17][18]. Results from a national survey study in China showed that 77% of the lung cancer patients had a presence of FT [19]. Immunotherapy is among the most expensive of the new treatments coming forth from cancer research [17,20].…”

Section: Introductionmentioning

confidence: 99%

Influence of financial toxicity on quality of life in lung cancer patients undergoing immunotherapy: the mediating effect of self-perceived burden

Zhang,

Xu,

Yang

et al. 2024

Preprint

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Background Although immunotherapy has the potential to prolong the median survival time and overall survival of patients with lung cancer, it is also a driver of immune related adverse events, which may directly affect the therapeutic effect and reduce quality of life (QOL). Attention to measure QOL in lung cancer patients undergoing immunotherapy is under-explored because of the therapy’s relative novelty. And a great deal of empirical researches has indicated the important influence of financial toxicity (FT) and self-perceived burden (SPB) on QOL. However, yet no research has ever clarified the relationship among FT, SPB, and QOL simultaneously. Hence, the purpose of this study is to understand the level of QOL of lung cancer patients undergoing immunotherapy, and attempt to clarify the potential mediating roles of SPB on the relationship between FT and QOL. Methods A convenience sample of 342 lung cancer patients undergoing immunotherapy was recruited from a cancer hospital from October 2022 to April 2023 in this cross-sectional study. Participants were requested to complete the structured questionnaires: sociodemographic and clinical questionnaire, Functional Assessment of Cancer Therapy–Lung (FACT-L), Self -Perceived Burden Scale (SPBS) and COmprehensive Score for financial Toxicity (COST). Data were subjected to Pearson correlation analysis and bootstrapping analysis in the structural equation modelling. Results The total score of FACT-L was (79.90 ± 15.84) points in 322 lung cancer patients administrated with immunotherapy. FT (β = 0.37, P < 0.01) and SPB (β = -0.27, P < 0.01) had a direct effect on QOL. In addition, SPB partly mediated the association between FT and QOL, and the standardized indirect effect was 0.19, accounting for 33.9% of the total effect. Conclusions The present study revealed that lung cancer patients undergoing immunotherapy experienced a lower QOL. And higher financial burden resulted in greater self-perceived burden, thus associated with inferior QOL. It is imperative for healthcare providers to routinely assessed QOL, financial toxicity or risk and self- perceived burden for lung cancer patients undergoing immunotherapy, and assist those patients in understanding the potential financial risk of each choice and help them take more active roles in their routine clinical care.

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Financial toxicity of patients with lung cancer in China: Results from a National Survey Study

Cited by 14 publications

References 46 publications

Financial toxicity of hidradenitis suppurativa: A single‐center experience at an urban wound‐care clinic

Financial toxicity of hidradenitis suppurativa: A single‐center experience at an urban wound‐care clinic

Health insurance as a moderator in the relationship between financial toxicity and medical cost‐coping behaviors: Evidence from patients with lung cancer in China

Influence of financial toxicity on quality of life in lung cancer patients undergoing immunotherapy: the mediating effect of self-perceived burden

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