A survey in Nepalese patients with acute leukaemia: a starting point for defining financial toxicity of cancer care in low-income and middle-income countries

Poudyal, Bishesh Sharma; Giri, Sanjit; Tuladhar, Sampurna; Neupane, Samir; Gyawali, Bishal

doi:10.1016/s2352-3026(20)30258-1

Cited by 24 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies reported from 12 to 34% of cancer patients experienced FT [21][22][23][24]. In the only study, we found from LMICs, 100% of Nepalese patients with acute leukaemia faced FT in which they had to either ask for charity from the public, borrow with interest or sell property to fund treatment [15]. The fact that the sample comprised largely poor people, treatment costs for this type of cancer were high, and there was no national HI system may have contributed to this extremely high rate [15].…”

Section: Discussionmentioning

confidence: 66%

“…In the only study, we found from LMICs, 100% of Nepalese patients with acute leukaemia faced FT in which they had to either ask for charity from the public, borrow with interest or sell property to fund treatment [15]. The fact that the sample comprised largely poor people, treatment costs for this type of cancer were high, and there was no national HI system may have contributed to this extremely high rate [15]. Nevertheless, the FT that (breast) cancer patients in Vietnam face is profound and there is a need to give priority to further research on this issue.…”

Section: Discussionmentioning

confidence: 95%

“…None of the three specific instruments for FT in cancer patients has been used or validated in LMICs [3,15]. In this paper, we used parameters from a previous study of FT in Nepal [15]-another LMIC-and adapted these using experience acquired from a previous study of BC patients in Vietnam [2] to examine the issue of FT in Vietnam. As such, we defined those who could not afford the costs of care with their liquid assets (i.e.…”

Section: Variables and Measurementsmentioning

confidence: 99%

See 2 more Smart Citations

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Ngan

Minh

Donnelly

et al. 2021

Support Care Cancer

View full text Add to dashboard Cite

Background This study examined the financial toxicity faced by breast cancer (BC) patients in Vietnam and the factors associated with the risk and degree of that toxicity. Methods A total of 309 BC patients/survivors completed an online survey (n=209) or a face-to-face interview (n=100) at two tertiary hospitals. Descriptive statistics and χ2 tests were used to identify and analyse the forms and degree of financial toxicity faced by BC patients/survivors. A Cragg hurdle model assessed variation in risk and the degree of financial toxicity due to treatment. Results 41% of respondents faced financial toxicity due to BC treatment costs. The mean amount of money that exceeded BC patients/survivors’ ability to pay was 153 million Vietnamese Dong (VND) ($6602) and ranged from 2.42 million VND to 1358 million VND ($104–58,413). A diagnosis at stage II or III of BC was associated with 16.0 and 18.0 million VND (~$690–777) more in the degree of financial toxicity compared with patients who were diagnosed at stage 0/I, respectively. Being retired or married or having full (100%) health insurance was associated with a decrease in the degree of financial toxicity. Conclusions A significant proportion of Vietnamese BC patients/survivors face serious financial toxicity due to BC treatment costs. There is a need to consider the introduction of measures that would attenuate this hardship and promote uptake of screening for the reduction in financial toxicity as well as the health gains it may achieve through earlier detection of cancer.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 95%

Section: Variables and Measurementsmentioning

confidence: 99%

See 1 more Smart Citation

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Ngan

Minh

Donnelly

et al. 2021

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…While exact definitions may vary, FT generally refers to the detrimental effects of cancer-directed therapy caused by out-of-pocket costs and lost productivity. FT is a patient-reported outcome that can be affected by many variables including insurance or payor coverage, geographic location, or cultural and personal factors [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Financial toxicity in hematological malignancies: a systematic review

et al. 2022

View full text Add to dashboard Cite

Hematologic malignancy outcomes have remarkably improved in the past decade with further advancement expected in future years. However, the detrimental effects of financial toxicity (FT) on patients with hematologic malignancies, because of both diagnoses and subsequent treatments, have not been studied comprehensively. We performed a systematic review of all studies reporting FT as a primary or secondary outcome among adult or pediatric patients with hematological malignancies. A total of 55 studies met the inclusion criteria for analysis. Across studies, 20–50% of patients reported some form of FT, including loss of work productivity, food and transportation costs, and depletion of savings. Younger age, lower-income level, unemployment, and rural residence were the most commonly identified risk factors for FT. Two studies looked at survival outcomes, with one reporting improvement in survival with a decrease in financial toxicity. However, significant heterogeneity in FT definitions was found between countries and payor systems. Only half of the studies (51%, n = 28) used validated survey instruments such as the COST assessment. The present systematic review identified that FT is common in patients with hematological malignancies and may be associated with poorer outcomes. However, studies of FT generally use non-standardized methods with cross-sectional analyses rather than longitudinal, prospective assessments. Further work is needed to standardize FT reporting and investigate measures to alleviate FT among patients with hematologic malignancies.

show abstract

“…Further, non‐documented HIV status may be a proxy for either not being tied into existing systems of care or lack of funds to procure additional test results, both of which may lead to reduced adherence. Finally, the high cost of immunohistochemistry likely makes it unaffordable to most patients 40 . Thus, those patients who were able to afford these immunohistochemistry results may be more able to afford and thus adhere to further care.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer in Zimbabwe: patterns of care and correlates of adherence in a national referral hospital radiotherapy center cohort from 2014 to 2018

et al. 2021

View full text Add to dashboard Cite

Background Breast cancer is the second most common cancer among women in Zimbabwe. Patients face socioeconomic barriers to accessing oncology care, including radiotherapy. We sought to understand patterns of care and adherence for women with breast cancer in sub‐Saharan Africa (SSA) with radiotherapy access. Methods A retrospective cohort was created for women with breast cancer evaluated at the Parirenyatwa Hospital Radiotherapy and Oncology Center (RTC) from 2014 to 2018. Clinical data were collected to define patterns of care. Non‐adherence was modeled as a binary outcome with different criteria for patients with localized versus metastatic disease. Results In total, 351 women presented with breast cancer with median age 51 at diagnosis (IQR: 43–61). Receptor status was missing for 71% (248). 199 (57%) had non‐metastatic disease, and 152 (43%) had metastases. Of women with localized disease, 34% received post‐mastectomy radiation. Of women with metastatic disease, 9.7% received radiotherapy. Metastatic disease and missing HIV status were associated with increased odds of study‐defined non‐adherence (aOR: 1.85, 95% CI: 1.05, 3.28; aOR: 2.13, 95% CI: 1.11, 4.05), while availability of ER/PR status was associated with lower odds of non‐adherence (aOR: 0.18, 95% CI: 0.09, 0.36). Conclusions Radiotherapy is likely underutilized for women with breast cancer, even in a setting with public sector availability. Exploring patient‐level factors that influence adherence to care may provide clinicians with better tools to support adherence and improve survival. Greater investment is needed in multidisciplinary, multimodality care for breast cancer in SSA.

show abstract

A survey in Nepalese patients with acute leukaemia: a starting point for defining financial toxicity of cancer care in low-income and middle-income countries

Cited by 24 publications

References 0 publications

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

Financial toxicity in hematological malignancies: a systematic review

Breast cancer in Zimbabwe: patterns of care and correlates of adherence in a national referral hospital radiotherapy center cohort from 2014 to 2018

Contact Info

Product

Resources

About