Dr Kwendakwema on the Effects of Financial Toxicity on Treatment Costs in Patients With Cancer

Natasha Kwendakwema, MD, hematology/oncology fellow, Fred Hutch Cancer Center, discusses findings from a study on the effects of adverse financial events on treatment costs at the end of life and health care utilization in patients with cancer.

Previous financial toxicity research demonstrated that patients with cancer have a higher risk of experiencing adverse financial events compared with people without cancer, Kwendakwema says. A study presented at the 2023 ASCO Annual Meeting aimed to determine how these adverse financial events, defined as third-party collections, charge-offs, delinquent mortgage payments, tax liens, repossessions, and foreclosures, affected health care utilization and outcomes at the end of life. This study used data from the Surveillance, Epidemiology, and End Results database linked with credit records, Medicare claims, and commercial payer claims for 13,545 patients with solid tumors. The investigators also collected data on emergency department and inpatient visits during patients’ last 3 months of life; patients’ place of death; and patients’ mean health care costs paid by their insurers. Patients had a median age of 75 years, and 54% were male.

This study found that 15.6% of patients experienced adverse financial events after their cancer diagnosis. In addition, patients who had adverse financial events were more likely to require multiple emergency department or inpatient visits during their last 3 months of life than those who did not have adverse financial events (odds ratio [OR], 1.19; CI, 1.07-1.34). Furthermore, patients experiencing adverse financial events were more likely to die in a hospital than those who did not experience these events (OR, 1.37; CI, 1.22-1.55). Moreover, mean total health care costs incurred by insurers were higher for patients who experienced adverse financial events in their last 6 months and 3 months of life, at $66,232 and $39,664, respectively, vs $55,831 and $33,638, respectively, for those who did not experience adverse financial events