Relative affluence no guarantee against financial toxicity occasioned by breast cancer
Whether poor, wealthy or somewhere in between, women being treated for breast cancer tend to suffer significant financial setbacks.
Unsurprisingly, those living in low- and middle-income countries, or LMICs, bear the biggest burden, affected at a nearly 80% clip of women hit by the disease.
However, more than a third of breast cancer patients in high-income countries, some 35%, experience hardship too.
Characterizing the association between cancer diagnosis and savings depletion as “financial toxicity,” the researchers who made the findings call for policies to “offset the burden of direct medical and nonmedical costs” with an eye on improving the financial health of vulnerable patients with breast cancer.
The study, a literature review and meta-analysis, was led by investigators at Harvard Medical School and published online in JAMA Network Open Feb. 8 [1].
Anam Ehsan, MBBS, Kavitha Ranganathan, MD, and colleagues analyzed 34 representative studies and conducted meta-analysis on another 18. All reviewed studies reported financial toxicity among breast cancer patients.
Assessing cancer stage and treatment alongside multiple variables—race, income, education, employment, insurance status, urban vs. rural residency—the team gauged financial toxicity based on income, out-of-pocket costs or patient-reported impact of monetary outlays from breast cancer diagnostics as well as treatment.
Along with the rates of financial toxicity among women living in the two income-based categories of countries, Ehsan and co-authors report the notably higher rate of hardship in breast cancer versus other health conditions.
Here they cite prior research showing typical financial toxicity rates across all health conditions in LMICs top out at around 12%.
“Our study demonstrates that financial toxicity prevalence among patients with breast cancer is substantially higher, with vulnerability compounded in LMICs,” they write in their discussion.
What’s more, they note, the financial burden brought on by breast cancer has been shown to exceed that associated with other cancers, “with substantially higher out-of-pocket costs than colorectal, lung and prostate combined.”
Ehsan and co-authors conclude that further efforts,
… ideally led by transnational organizations, are required to thoroughly characterize financial toxicity burden in a standardized fashion across different settings. Policy interventions to improve breast cancer education, expand health care coverage, enhance patient support for nonmedical costs, and invest in health care infrastructure could improve both financial and health outcomes among patients with breast cancer at risk for financial toxicity.”
The study is available in full for free.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.