Assessing the Relationship between Socio-demographic, Clinical Profile and Financial Toxicity: Evidence from Cancer Survivors in Sarawak

Yap, Shee-Ling; Wong, Shirly Siew-Ling; Chew, Keng-Sheng; Siew, Ke-Lin

doi:10.31557/apjcp.2020.21.10.3077

Cited by 10 publications

(16 citation statements)

References 30 publications

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“…An educational level of less than or equal to 12 years was a significant predictor of higher financial needs, which is similar to the results of our previously studied adult cancer survivors population [13]. Previous reports from the literature also reported unmet needs to be greatest in those with lower educational status, which could be attributed to lower chances of finding good jobs; therefore, as discussed above financial hardships are expected to be higher [26,38].…”

Section: Discussionsupporting

confidence: 88%

Mapping the Supportive Care Needs of Adult Survivors of Childhood Cancer at a Comprehensive Cancer Center in the Middle East

Al-Rawashdeh,

Damsees,

Abaza

et al. 2023

Preprint

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Assessing unmet needs is crucial to achieving quality care and patient satisfaction. Between September and December 2021, we assessed unmet supportive care needs in a consecutive sample of adult survivors of childhood cancer at KHCC. Two hundred and ninety-seven adult survivors of childhood cancer completed the study questionnaire. Overall needs score across all domains was (24.80$\pm$19.65), with the financial domain scoring the highest (30.39$\pm$31.95) and sexuality scoring the lowest (7.67$\pm$19.67). Using a multivariate linear regression model, female gender was independently associated with significantly high scores in all need domains (p$<$0.001), except for sexuality. Monthly income, comorbidities, socioeconomic challenges, time since diagnosis, and age at diagnosis have emerged as predictors of needs in many domains. Mean quality of life (QoL) was significantly and inversely associated with the mean score in multiple domains: psychological (p$<$0.001), sexuality (p=0.038), financial (p$<$0.001), and overall needs (p=0.004). Following a thematic analysis of qualitative data, educational difficulties and work-related challenges were identified as other unmet needs. Cancer experiences during childhood significantly influence supportive care needs in adulthood. There is a need for more tailored studies assessing different populations of cancer survivors and avoiding the “one size fits all” model when it comes to survivorship care.

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Section: Discussionsupporting

confidence: 88%

Mapping the Supportive Care Needs of Adult Survivors of Childhood Cancer at a Comprehensive Cancer Center in the Middle East

Al-Rawashdeh,

Damsees,

Abaza

et al. 2023

Preprint

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“…Groups at highest risk include new immigrants, visible minorities, those without private health coverage, or those on sick leave. [34][35][36][37][38] In several studies, higher out-of-pocket costs correlated with financial toxicity and decreased treatment adherence. For example, patients with chronic myeloid leukemia in the United States who had higher prescription copayments were almost twice as likely to stop expensive life-prolonging therapy compared with those who had lower copayments, leading to worse outcomes.…”

Section: The Impact On Patients With Cancermentioning

confidence: 99%

An Arm and a Leg: The Rising Cost of Cancer Drugs and Impact on Access

Leighl

Nirmalakumar

Ezeife³

et al. 2021

American Society of Clinical Oncology Educational Book

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Increasing cancer drug prices present global challenges to treatment access and cancer outcomes. Substantial variability exists in drug pricing across countries. In countries without universal health care, patients are responsible for treatment costs. Low- or middle-income countries are heavily impacted, with limited patient access to novel cancer treatments. Financial toxicity is seen across cancer types, countries, and health care systems. Those at highest risk include younger patients, new immigrants, visible minority groups, and those without private health coverage. Currently, cancer drug pricing does not correlate with value or clinical benefit. Value-based pricing of oncology drugs may incentivize development of higher-value medicines and eliminate excess spending on drugs that yield little benefit. Generics and biosimilars in oncology can also improve affordability and patient access, offering dramatic reductions in drug spending while maintaining patient benefit. Oncologists can promote value-based care by following evidence-based clinical guidelines that avoid low-value treatments. Researchers can also engage in value-based research that critically explores optimal cancer drug dosing, schedules, and treatment duration and defines patient populations most likely to benefit (e.g., through biomarker selection). Cancer Groundshot proposes that we improve outcomes for today's patients with cancer, including broader global access for high-value treatments, promotion of affordable cancer control strategies, and reduction of cancer morbidity and mortality through low-cost prevention and screening initiatives. Moving forward, major oncology societies recommend promoting uniform global access to essential cancer medicines and avoiding financial harm for patients as key principles in addressing the affordability of cancer drugs.

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“…The latest analysis showed that Malaysia has a UHC effective coverage index higher than the neighbouring countries such as Indonesia, Myanmar and others [56]. Few initiatives were also implemented to reduce the financial barrier to healthcare such as the PeKa B40, mySalam, Bantuan Sara Hidup (BSH) programme, and others which are directly and indirectly cater to the needs of the population to seek healthcare [33]. It is no surprise that the results of the current study showed that the prevalence of distress financing is more concentrated among poor households.…”

Section: Discussionmentioning

confidence: 99%

“…Other medical protection programmes include, but are not limited to; (1) Social Security Organisation (SOCSO) and Employee Provident Funds (EPF), which are two social security funds in Malaysia that provide health coverage for employees working in the private sector; (2) employer insurance scheme, which is provided by some employers in private sectors to their employees; and (3) guarantee letters for the government servants, which allows free health provision among the government servants [32]. Other health financing initiatives provided by the governments for accessing healthcare services include those catered for the bottom 40% of population (B40) groups such as Skim Peduli Kesihatan for the B40 (PeKa B40) and mySalam [33].…”

Section: Introductionmentioning

confidence: 99%

The inequalities and determinants of Households’ Distress Financing on Out-off-Pocket Health expenditure in Malaysia

et al. 2022

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Background Out-of-pocket (OOP) payments for healthcare services potentially have severe consequences on households, especially among the poor. Under certain circumstances, healthcare payments are financed through selling household assets, or borrowings. This certainly could influence households’ decision, which likely resorts to forgoing healthcare services. Thus, the focal point of this study is aimed to identify the inequalities and determinants of distress financing among households in Malaysia. Methods This study used secondary data from the National Health and Morbidity Survey (NHMS) 2019, a national cross-sectional household survey that used a two-stage stratified random sampling design involving 5,146 households. The concentration curve and concentration index were used to determine the economic inequalities in distress financing. Whereas, the determinants of distress financing were identified using the modified Poisson regression model. Results The prevalence of borrowing without interest was the highest (13.86%), followed by borrowing with interest (1.03%) while selling off assets was the lowest (0.87%). Borrowing without interest was highest among rural (16.21%) and poor economic status (23.34%). The distribution of distress financing was higher among the poor, with a concentration index of -0.245. The modified Poisson regression analysis revealed that the poor, middle, rich, and richest had 0.57, 0.58, 0.40 and 0.36 times the risk to develop distress financing than the poorest socio-economic group. Whereas, the presence of one and two or more elderly were associated with a 1.94 and 1.59 times risk of experiencing distress financing than households with no elderly members. The risk of developing distress financing was also 1.28 and 1.58 times higher among households with one and two members receiving inpatient care in the past 12 months compared to none. Conclusions The findings implied that the improvement of health coverage should be emphasized to curtail the prevalence of distress financing, especially among those caring for the elderly, requiring admission to hospitals, and poor socio-economic groups. This study could be of interest to policymakers to help achieve and sustain health coverage for all.

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Assessing the Relationship between Socio-demographic, Clinical Profile and Financial Toxicity: Evidence from Cancer Survivors in Sarawak

Cited by 10 publications

References 30 publications

Mapping the Supportive Care Needs of Adult Survivors of Childhood Cancer at a Comprehensive Cancer Center in the Middle East

Mapping the Supportive Care Needs of Adult Survivors of Childhood Cancer at a Comprehensive Cancer Center in the Middle East

An Arm and a Leg: The Rising Cost of Cancer Drugs and Impact on Access

The inequalities and determinants of Households’ Distress Financing on Out-off-Pocket Health expenditure in Malaysia

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