期刊
ONCOLOGIST
卷 26, 期 7, 页码 588-596出版社
WILEY
DOI: 10.1002/onco.13767
关键词
Economic burden of disease; Clinical trials as topic; Oncology; Medical; Clinical trial; Phase I; Out‐ of‐ pocket costs
类别
资金
- Conquer Cancer Foundation
- National Cancer Institute [R01CA225647]
- Health Care Services Corporation/Blue Cross Blue Shield of Texas
The study surveyed the economic burden and financial toxicity in cancer patients participating in clinical trials, revealing a high economic burden with most of the out-of-pocket costs being nonmedical. Patients with lower income and who traveled farther experienced worse financial toxicity, while non-White or Hispanic patients were more likely to encounter unexpected medical costs.
Background Clinical trials are an important therapeutic option for patients with cancer. Although financial burden in cancer treatment is well documented, the financial burden associated with clinical trials is not well understood. Patients and Methods We conducted a survey regarding economic burden and financial toxicity in patients with cancer enrolled in phase I clinical trials for >1 month. Financial toxicity score was assessed using the Comprehensive Score for Financial Toxicity survey. Patients also reported monthly out-of-pocket (OOP) costs. Results Two hundred and thirteen patients completed the survey (72% non-Hispanic White; 45% with annual income <=$60,000; 50% lived >300 miles from the clinic; 37% required air travel). Forty-eight percent of patients had monthly OOP costs of at least $1,000. Fifty-five percent and 64% of patients reported unanticipated medical and nonmedical expenses, respectively. Worse financial toxicity was associated with yearly household income <$60,000 (odds ratio [OR]: 2.7; p = .008), having unanticipated medical costs (OR: 3.2; p = .024), and living >100 miles away from the clinical trial hospital (OR: 2.3; p = .043). Non-White or Hispanic patients (OR: 2.5; p = .011) and patients who were unemployed or not working outside the home (OR: 2.5; p = .016) were more likely to report high unanticipated medical costs. Conclusion Among patients with cancer participating in clinical trials, economic burden is high, and most of patients' OOP costs were nonmedical costs. Financial toxicity is disproportionally higher in patients with lower income and those who travel farther, and unexpected medical costs were more common among non-White or Hispanic patients. OOP costs can be substantial and are often unexpected for patients. Implications for Practice The financial burden of cancer treatment is well documented, but there are limited data regarding the financial burden associated with cancer clinical trials. This study surveyed 213 patients enrolled in early-phase clinical trials. Monthly out-of-pocket costs were at least $1000 for nearly half of patients. Worse financial toxicity was associated with income <$60,000 and living farther away from the hospital. Racial/ethnic minorities had higher rates of unanticipated medical costs. These data help to quantify the high financial burden for patients and may reveal a cause of disparities in clinical trial enrollment for underrepresented populations.
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