Factors associated with humanistic burden and indirect cost among patients with cancer in Japan

Abstract

Aims: Patients with cancer experienced reduced health-related quality-of-life (HRQoL), increased work productivity and activity impairment (WPAI), and indirect costs. With the current emphasis on economic evaluation of health technology in Japan, it is important to understand how indirect costs correlate with HRQoL and patient characteristics. It is also crucial to assess the patient characteristics associated with the HRQoL, WPAI, and indirect costs among patients with any types of cancer. Materials and methods: This cross-sectional study used data from the 2017 Japan National Health and Wellness Survey (NHWS). Respondents self-reported their HRQoL and WPAI by answering validated SF-12v2 and WPAI questionnaires, respectively. Indirect costs were derived using the human capital method. Correlation between HRQoL components and indirect costs were assessed using Spearman's rank-order correlation. Correlation between patient characteristics and HRQoL, WPAI, and indirect costs were analyzed using generalized linear models. Results: A total of 1,540 patients with any types of cancer, 254 with breast cancer, and 144 with colorectal cancer were included in the analyses. There was significant negative correlation between the indirect costs and HRQoL components among patients with any types of cancer. Patients with lower comorbid burden, higher household income, employed, married, or living with partner, never smokers, and exercised tended to have higher HRQoL. Being never smokers, having lower comorbid burden, normal weight, and exercised were associated with lower WPAI measures. Additionally, patients who were older, not married, not obese, and not smoking tended to incur lower indirect costs. Conclusions: The negative correlation between HRQoL and indirect costs among patients with cancer emphasized the needs to improve health outcomes and reduce indirect costs of patients. The factors associated with cancer burden identified in this study provide insights to allow targeted intervention to improve HRQoL and lessen the WPAI and indirect cost among cancer patients in Japan.

Cancer treatment-related financial toxicity in Japan: a scoping review

“…Coping with financial toxicity includes trimming household finances (Honda et al, 2019), using savings to pay for cancer treatment (Honda et al, 2018(Honda et al, , 2019Sasaki et al, 2022), consulting with healthcare providers (Sasaki et al, 2022), deepening the understanding of public financial support systems and medical service contents, such as sickness benefits and medical expense deduction (Komura et al, 2011;Osono et al, 2012;Tsuchiya et al, 2018), building good relationships between patients and families (Sugiyama et al, 2017), and obtaining appropriate insurance (Takura et al, 2016;Ohno et al, 2020b;Sasaki et al, 2022). Among outpatients who were working when they were diagnosed with cancer, around 70% used high-cost medical expenses, 20% used the sickness benefit, and 40% used the medical expense deduction; information obtained either by the patients or by their family members, or given by healthcare providers was relatively low (Tsuchiya et al, 2018).…”