Effects of financial toxicity on prescription drug use and mental well-being in cancer patients

• Published in: Exploratory research in clinical and social pharmacy 2022-06, Vol.6, p.100136-100136, Article 100136
• Main Authors: Chan, Kelly, Sepassi, Aryana, Saunders, Ila M., Goodman, Aaron, Watanabe, Jonathan H.
• Format: Article
• Language: English
• Subjects: Cancer; Financial toxicity; Value-based pricing
• ISSN: 2667-2766; 2667-2766
• DOI: 10.1016/j.rcsop.2022.100136

In the US, medical costs for cancer patients have grown from $27 billion in 1990 to $174 billion in 2020. The increased financial strain that cancer patients and survivors endure is referred to as financial toxicity. To quantify the relationship between indicators of financial toxicity and health utilization and quality of life in patients ever diagnosed with cancer. Adult cancer patients and survivors in 2017 were identified using the Medical Expenditure Panel Survey. Multiple logistic regression models were used to quantify the relationship between three financial toxicity exposures (concern for keeping an income, paying large medical bills, and going into debt or borrowing money) and two discrete outcomes of being able to purchase prescriptions and often worrying that cancer would worsen or come back. This study assessed 609 respondents. After survey weighting was applied, that represented 16,215,673 individuals. Patients who reported concern for keeping an income were at 2.91 (95% Confidence Interval [CI], 1.16 to 7.31) and 2.97 (95% CI, 2.01 to 2.67) times increased odds to report avoiding purchase of prescriptions and worry of cancer status, respectively, versus those who did not. Patients who reported worry about paying large medical bills were at 4.46 (95% CI, 2.15 to 9.24) and 2.80 (95% CI, 1.98 to 3.96) times increased odds to report avoiding purchase of prescriptions and worry of cancer status, respectively, versus those who did not. Patients who reported borrowing money or going into debt were at 3.04 (95% CI, 1.19 to 7.76) and 2.42 (95% CI, 1.54 to 3.18) times increased odds to report avoiding purchase of prescriptions and worry of cancer status, respectively, versus those who did not. Financial toxicity is associated with decreased prescription utilization and quality of life in the form of excessive worry among cancer patients including cancer survivors. •Background: In the U.S., medical costs of cancer have increased from $27 billion in 1990 to $174 billion in 2020.•Patients with cancer carry the burden of paying higher out-of-pocket costs for their care than those without cancer.•The increased financial strain that patients and survivors with cancer is referred to as financial toxicity.•Findings: Patients and survivors with cancer who reported ever being concerned about income, ever being worried about paying large medical bills, or ever going into debt or had a family member go into debt were at higher odds to report not receiving prescri