Time-Related Burdens of Cancer Care

Gupta, Arjun; Jensen, Eric H.; Virnig, Beth A; Beg, Muhammad Shaalan

doi:10.1200/op.21.00662

Cited by 29 publications

(28 citation statements)

References 6 publications

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“…Treatment-related time toxicity is relevant across all illnesses (cancer and noncancer) and settings (curative and palliative), but may be most relevant in people with advanced cancer who face treatment decisions in the context of limited time. [4][5][6] In making these decisions, patients want to know where and how they will spend their time, not just how much time they might gain. For example, a patient may view treatments differently if they knew that, on average, 3 of their remaining estimated 9 months alive would be spent away from home (eg, in infusions and in the hospital) if they pursue treatment option A, but that all of their estimated remaining 7 months would be spent at home if they pursued option B (Fig 1).…”

Section: Time Toxicitymentioning

confidence: 99%

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The Time Toxicity of Cancer Treatment

Gupta

Eisenhauer

Booth

2022

JCO

Self Cite

143

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Section: Time Toxicitymentioning

confidence: 99%

“…In addition, inherent limitations associated with retrospective data capture (eg, incomplete data, only capturing oncology-related visits, etc) can underestimate true time toxicity. 4,15 Clinical trials represent an ideal context in which to quantify this phenomenon prospectively.…”

Section: Time Toxicitymentioning

confidence: 99%

The Time Toxicity of Cancer Treatment

Gupta

Eisenhauer

Booth

2022

JCO

Self Cite

143

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“…People with cancer already spend a significant portion of their time pursuing cancer-related care. 1,3,21-23 Adding to confusion and logistic burdens, for a pharmacy that appears on the GoodRx page for zip code 55455, the closest physical pharmacy is almost 400 miles away in Sterling, IL.…”

Section: Discussionmentioning

confidence: 99%

“…People with cancer face significant economic and time burdens associated with cancer-directed treatment and supportive care. 1-3 Recently, the costs of symptom control medications have received attention as an important source of financial toxicity for people with cancer. 4,5 These costs have traditionally been under-recognized since symptom control medications are often over-the-counter or lower-cost generic formulations.…”

Section: Introductionmentioning

confidence: 99%

Finding the Lowest-Cost Pharmacy for Cancer Supportive Care Medications: Not So Easy

Etteldorf

Rotolo

Sedhom

et al. 2022

JCO Oncology Practice

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PURPOSE: To decrease the financial burden on people with cancer, clinicians and patients increasingly use medication price comparison websites to seek pharmacies where medications may be cheaper. Shopping around at different pharmacies can add additional time and logistic burden to patients and care partners. We sought to determine whether a single pharmacy consistently offered the lowest price for symptom control medications. METHODS: We compiled medications/formulations used to manage two common cancer-associated symptoms: nausea/vomiting and anorexia/cachexia. We extracted discounted, lowest price with coupon prices for a typical fill of these medications at nine pharmacies in Minneapolis, MN, using GoodRx. We compared prices across formulations and pharmacies to assess whether a pharmacy consistently offered the lowest price. RESULTS: We included 24 formulations for nausea/vomiting (14 generic and 10 brand-name) and 19 for anorexia/cachexia (12 generic and seven brand-name). Prices for brand-name formulations were similar across pharmacies, but prices of generic formulations varied widely across pharmacies. For example, the prices of a seven-unit fill of generic 5-mg olanzapine tablets ranged from $4 to $57 US dollars. No single pharmacy consistently offered the lowest price across the formulations studied. For example, for the 12 generic formulations for anorexia/cachexia, one pharmacy had the highest price for four formulations and the lowest price for two others. CONCLUSION: In this study of discounted medication prices, we found that no single pharmacy in an urban zip code consistently offered the lowest price for medications used to manage two common cancer-associated symptoms. Well-intentioned efforts to pursue the cheapest source of each medication by visiting multiple pharmacies may add extra time and logistic toxicity to patients and care partners. This approach can increase redundant scripts and expose patients to medication-related adverse events.

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“…Our estimates of almost 16 hours each month on treatment-related activities are likely underestimated due to inability to capture time spent being treated for adverse events. 4 Additionally, these 16 hours may be distributed over at least 4-5 days per month, leading to fewer treatment-free ‘home days’. 5 Time estimates were based on process mapping via direct observation in oncology clinics and patient surveys but applied to only the minimal frequency of visits for trial participation.…”

Section: Discussionmentioning

confidence: 99%

Estimation of time cost of anti-cancer drugs approved based on comparisons to best supportive care: a cross sectional analysis

Prasad

Thibault

Chen

et al. 2022

Preprint

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Background: Financial costs from cancer treatment are increasingly recognized, but what has historically been underrecognized is the time cost of therapy. We sought to estimate the time burden of anti-cancer drugs approved based on comparisons to best supportive care (BCS), with the assumption that without this drug, a patient could have been treated with observation, home palliative care or hospice services, with minimal time seeking medical care. Methods: We searched all FDA approvals (2009 - March 2022) for randomized trials that used BCS as a treatment option for an anti-tumor drug in the metastatic setting and abstracted data on treatment related activities. We then estimated time spent on these activities using previously calculated times. Results: Of the 13 drugs tested against BSC, nine studies demonstrated an improvement in median OS (median 2.1 months). The median monthly time spent for patients in the intervention arm of BSC trials was 15.8 hours. Conclusion: Time is a valuable resource for people who have cancer, but especially for patients who may have few to no remaining treatment options, and yet, we found that patients can spend up to 16 hours in anti-cancer drug related activities per month.

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Time-Related Burdens of Cancer Care

Cited by 29 publications

References 6 publications

The Time Toxicity of Cancer Treatment

The Time Toxicity of Cancer Treatment

Finding the Lowest-Cost Pharmacy for Cancer Supportive Care Medications: Not So Easy

Estimation of time cost of anti-cancer drugs approved based on comparisons to best supportive care: a cross sectional analysis

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