On the origin of financial toxicity for cancer patients

Abstract

The rapid growth in cancer treatment pricing has produced a new type of adverse effect for patients called “financial toxicity”. Financial toxicity involves an increased likelihood that cancer patients will experience bankruptcy, relationship problems, and even mortality. Although several factors have been identified that can contribute to financial toxicity for cancer patients, this is the first study to use both logistic regression and cost-benefit analysis to evaluate those factors that contribute most to financial toxicity. Logistic regression was used to assess information on 559 cancer patients from the 2016 United States National Health Interview Survey, while incremental cost- effectiveness ratios (ICERs) were used to assess various cancer drugs. Besides previously identified factors that can contribute to financial toxicity, e.g., age, poor health status, insurance coverage, race etc., this analysis showed that younger age, inpatient care, and excessive cancer drug costs for advanced-stage cancer were the most important factors for predicting financial burden. Cost-benefit analysis showed that cancer drug cost was often not proportional to therapeutic efficacy for many advanced-stage cancers. Although financial toxicity has dire implications for patient health and societal healthcare spending, economic and therapeutic strategies are presented that could help reduce this growing problem.