Prevalence of Financial Toxicity Among Gynecologic Cancer Patients Initiating New Treatment

A cross-sectional study evaluated the financial burden associated with beginning a new line of treatment for gynecologic cancer. According to the research, 61% of these patients experience financial toxicity. The data were presented during a scientific plenary discussing the challenges associated with cancer care delivery at the Society of Gynecologic Oncology 50th Annual Meeting.

For the study, researchers conducted a survey (via telephone or in-person at a tertiary-care referral center) of gynecologic patients who had started a new line of systemic therapy within the prior eight weeks. Financial toxicity was defined as a Comprehensive Score for Financial Toxicity (COST) < 26, and a three-point scale was used to grade financial toxicity severity. The researchers also evaluated opportunity costs through changes in the patients’ employment and spending.

Among the 79 patients who responded to the survey, 58% were on first-line treatment, and the remaining 42% were on subsequent-line treatment. Average patient age was 59 years and ranged from 33–80 years. Most patients (71%) were white, and 28% were black. The majority of patients (72%) had private insurance, while 22% only had public insurance and 6% were uninsured. Just over half of patients (52%) reported an annual household income < $40,000. A total of 61% of patients had financial toxicity, of which 43% had mild grade 1 and 18% had moderate grade 2. Patients with financial toxicity, compared to those without, were significantly more likely to have ever lost wages (53% vs. 19%), had to borrow money (40% vs. 3%), altered their spending habits (83% vs. 35%), sacrificed other things (68% vs. 19%), and not paid bills on time (40% vs. 13%); they were also more likely to report that their household income was not enough to pay for their basic needs (31% vs. 10%) or medical care needs (46% vs. 13%). Other outcomes associated with financial toxicity included unemployment (n = 4), filing for bankruptcy (n = 1), selling a house (n = 1), and getting a second job (n = 1). Income < $40,000 was identified as an independent risk factor of financial toxicity; there was no association between financial toxicity and age, race, private vs. public insurance, and first vs. subsequent line of treatment.

Liang M, Summerlin S, Cohen A, et al. The cost of treatment: Financial toxicity and opportunity costs among gynecologic cancer patients starting a new line of treatment. Presented at the Society of Gynecologic Oncology 50th Annual Meeting.