The patient-level effect of the cost of Cancer care - financial burden in German Cancer patients.
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms
/ economics
Cost of Illness
Cross-Sectional Studies
Employment
/ economics
Female
Germany
Health Expenditures
/ statistics & numerical data
Humans
Male
Middle Aged
Neuroendocrine Tumors
/ economics
Patient Reported Outcome Measures
Prospective Studies
Quality of Life
Surveys and Questionnaires
/ statistics & numerical data
Young Adult
Financial burden
Financial toxicity
Income loss
Out-of-pocket costs
Patient-reported outcomes
Quality of life
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
05 Jun 2020
05 Jun 2020
Historique:
received:
04
12
2019
accepted:
01
06
2020
entrez:
7
6
2020
pubmed:
7
6
2020
medline:
20
1
2021
Statut:
epublish
Résumé
Financial toxicity of cancer has so far been discussed primarily in the US health care system and is associated with higher morbidity and mortality. In European health care systems, the socio-economic impact of cancer is poorly understood. This study investigates the financial burden and patient-reported outcomes of neuroendocrine (NET) or colorectal (CRC) cancer patients at a German Comprehensive Cancer Center. This prospective cross-sectional study surveyed 247 advanced stage patients (n = 122 NET/n = 125 CRC) at the National Center for Tumor Diseases, in Germany about cancer-related out-of-pocket costs, income loss, distress, and quality of life. Multiple linear regression analysis was performed to demonstrate the effects of economic deterioration on patients' quality of life and distress. 81% (n = 199) of the patients reported out-of-pocket costs, and 37% (n = 92) income loss as a consequence of their disease. While monthly out-of-pocket costs did not exceed 200€ in 77% of affected patients, 24% of those with income losses reported losing more than 1.200€ per month. High financial loss relative to income was significantly associated with patients' reporting a worse quality of life (p < .05) and more distress (p < .05). Financial toxicity in third-party payer health care systems like Germany is caused rather by income loss than by co-payments. Distress and reduced quality of life due to financial problems seem to amplify the burden that already results from a cancer diagnosis and treatment. If confirmed at a broader scale, there is a need for targeted support measures at the individual and system level.
Sections du résumé
BACKGROUND
BACKGROUND
Financial toxicity of cancer has so far been discussed primarily in the US health care system and is associated with higher morbidity and mortality. In European health care systems, the socio-economic impact of cancer is poorly understood. This study investigates the financial burden and patient-reported outcomes of neuroendocrine (NET) or colorectal (CRC) cancer patients at a German Comprehensive Cancer Center.
METHODS
METHODS
This prospective cross-sectional study surveyed 247 advanced stage patients (n = 122 NET/n = 125 CRC) at the National Center for Tumor Diseases, in Germany about cancer-related out-of-pocket costs, income loss, distress, and quality of life. Multiple linear regression analysis was performed to demonstrate the effects of economic deterioration on patients' quality of life and distress.
RESULTS
RESULTS
81% (n = 199) of the patients reported out-of-pocket costs, and 37% (n = 92) income loss as a consequence of their disease. While monthly out-of-pocket costs did not exceed 200€ in 77% of affected patients, 24% of those with income losses reported losing more than 1.200€ per month. High financial loss relative to income was significantly associated with patients' reporting a worse quality of life (p < .05) and more distress (p < .05).
CONCLUSIONS
CONCLUSIONS
Financial toxicity in third-party payer health care systems like Germany is caused rather by income loss than by co-payments. Distress and reduced quality of life due to financial problems seem to amplify the burden that already results from a cancer diagnosis and treatment. If confirmed at a broader scale, there is a need for targeted support measures at the individual and system level.
Identifiants
pubmed: 32503459
doi: 10.1186/s12885-020-07028-4
pii: 10.1186/s12885-020-07028-4
pmc: PMC7275553
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
529Subventions
Organisme : Ipsen Biopharmaceuticals
ID : ESS A-DE-52030-362
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