Financial toxicity in patients with colorectal cancer and neuroendocrine tumors.

Apostolidis, Leonidas; Mehlis, Katja; Witte, J.; Surmann, Bastian; Kudlich, Matthias; Walther, Jürgen; Greiner, Wolfgang; Winkler, Eva C.

doi:10.1200/jco.2018.36.15_suppl.6533

Cited by 4 publications

(13 citation statements)

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“…With an average job income of 15,613 euros prior to reporting a cancer diagnosis, the econometric models in this study forecasted an absolute fall in job income per patient between 4059 euros and 4371 euros per year, or between 338 euros and 364 euros per month, during those years in which a cancer diagnosis was reported. Corresponding numbers were between 100 to 500 euros per month for 60% of cancer patients in Bikowski, 14 and below 800 euros per month for 87% of cancer patients in Apostolidis, Mehlis 13 and for 83% of cancer patients in Mehlis, Witte 12 . Our estimation, however, disentangles the effect of a cancer diagnosis from that of comorbidities, gender, household position, age, education level, and working status, whereas results from the previous research do not.…”

Section: Discussioncontrasting

confidence: 79%

“…The fact that anti‐cancer treatments and medications are commonly accessible and the extent of social security is ample, unlike in some other countries in Europe, reinforces the belief that financial hardship is not a major concern for cancer patients in Germany 22,23 . Contrary to this view, some previous studies based on hospital surveys suggest that cancer patients do face important OOP expenses and, mostly notably, large losses in income in Germany 13–19 . This study provides evidence on the magnitude of absolute income loss at a national level and overcomes shortcomings in previous literature to more precisely measure the impact of a cancer diagnosis.…”

Section: Discussionmentioning

confidence: 51%

“…This geographical bias likely responds to financial stress associated with cancer treatment being less pronounced under healthcare systems with uniform coverage and capped co‐payments, 12 leading to the perception that financial vulnerability is non‐existent for cancer patients when access to healthcare is universal. Contrary to this expectation, the few existing studies reveal that financial hardship is not uncommon among cancer patients in Germany 13–19 . These are mostly based on single hospital surveys, and to our knowledge, there is not currently any research performed at the national level.…”

Section: Introductionmentioning

confidence: 77%

“…An earlier survey by Bikowski 14 examined 154 cancer patients at the National Center for Tumor Disease (NCT) in Heidelberg and showed drops in monthly income from work to be between 100 and 500 euros for more than 60% of those surveyed, and greater than 1200 euros for 12%. A series of studies involving 247 advanced stage patients with colorectal and neuroendocrine tumors performed also at the NCT in Heidelberg found that around a third of the sample patients stated a significant drop in net household income after diagnosis 12,13,17–19 . In two of these studies, patients who reported a net household income loss indicated this amount to be at least 800 euros per month in 44% and 45% of the cases, respectively 12,13 .…”

Section: Introductionmentioning

confidence: 99%

“…A series of studies involving 247 advanced stage patients with colorectal and neuroendocrine tumors performed also at the NCT in Heidelberg found that around a third of the sample patients stated a significant drop in net household income after diagnosis 12,13,17–19 . In two of these studies, patients who reported a net household income loss indicated this amount to be at least 800 euros per month in 44% and 45% of the cases, respectively 12,13 . Moreover, one of these studies revealed that income losses outweigh OOP costs.…”

Section: Introductionmentioning

confidence: 99%

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Income loss after a cancer diagnosis in Germany: An analysis based on the socio‐economic panel survey

Hernández

Schlander

2021

Cancer Medicine

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Background and Aims Cancer treatments often require intensive use of healthcare services and limit patients’ ability to work, potentially causing them to become financially vulnerable. The present study is the first attempt to measure, on the German national level, the magnitude of absolute income loss after a cancer diagnosis. Methods This study analyzes data from the Socio‐Economic Panel (SOEP) survey, one of the largest and most comprehensive household surveys in Germany, consisting of approximately 20,000 individuals, who are traced annually. The empirical strategy consists of ordinary least squares (OLS) and multinomial logistic estimators to measure changes in job income, work status, working hours, and pension as a result of reporting a cancer diagnosis for the period between 2009 and 2015. Sample consistency checks were conducted to limit measurement error biases. Results Our results show that job incomes dropped between 26% and 28% within the year a cancer diagnosis was reported. The effect persisted for two years after the diagnosis and was no longer observable after four years. The finding was linked to an increased likelihood of unemployment and a reduction of working hours by 24%. Pension levels, on the other hand, were not affected by a cancer diagnosis. Conclusions These findings suggest that many cancer patients are exposed to financial hardship in Germany, particularly when the cancer diagnosis occurs during their working age and before requirements to obtain a pension are met. Further research seems warranted to identify particularly vulnerable patient groups.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Income loss after a cancer diagnosis in Germany: An analysis based on the socio‐economic panel survey

Hernández

Schlander

2021

Cancer Medicine

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The association of health insurance literacy and numeracy with financial toxicity and hardships among colorectal cancer survivors

Edward

Rayens

Zheng

et al. 2021

Support Care Cancer

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Purpose-In this study, we examined the association of financial hardship measured by material financial burden and financial toxicity with health insurance literacy and numeracy among colorectal cancer survivors. The lack of evidence on the impact of cost-related health literacy, specifically health insurance literacy and numeracy, on financial toxicity among cancer survivors warrants further research.Methods-Between January and November 2019, we used a cross-sectional research design to collect surveys from 104 colorectal cancer survivors (diagnosed within last 5 years) from the Kentucky Cancer Registry. Survey items assessed health insurance literacy (measured by confidence and behaviors in choosing and using health insurance), numeracy, material financial burden, and financial toxicity, in addition to socio-demographic variables. Survey data were subsequently linked to the participant's cancer registry record. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses.

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Out-of-pocket payments and loss of income among long-term breast cancer survivors in Germany: a multi-regional population-based study

et al. 2022

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Purpose This study aims to examine the magnitude of out of pocket (OOP) payments and income loss, as well as to identify socioeconomic and clinical factors among long-term breast cancer (BC) survivors in Germany. Methods We examine data from 2654 long-term BC survivors in Germany that participated in the “CAncEr Survivorship – A multi-Regional population-based study” (CAESAR) and who were at least 5 years post diagnosis. BC-related OOP payments and income loss both within the 12 months prior to the survey were analyzed. Two-part regression models were performed to identify socioeconomic and clinical factors. Results OOP payments were incurred by 51.9% of survivors with a total mean spending of 566 euros. Income loss was present among 9.6% of survivors and averaged 5463 euros among those reporting such. Socioeconomic and clinical factors associated with higher OOP payments (p ≤ 0.05) included age at time of diagnosis (65–79 years), education (10–11 years), (early) retirement, stage of diagnosis (stage III), time from diagnosis (more than 10 years), comorbidities (at least 1), and the use of rehabilitation services. Regarding income loss, age at time of diagnosis (50–59 years), (early) retirement, stage of diagnosis (stage II), time from diagnosis (5–7 years), comorbidities (at least 1), and receiving chemotherapy treatment were associated with higher losses. Conclusions For some survivors in Germany, financial burden can be considerably high despite comprehensive healthcare and support from social security. Implications for Cancer Survivors OOP payments related to domestic help and nursing staff as well as to outpatient care are most frequent.

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Financial toxicity in patients with colorectal cancer and neuroendocrine tumors.

Cited by 4 publications

References 0 publications

Income loss after a cancer diagnosis in Germany: An analysis based on the socio‐economic panel survey

Income loss after a cancer diagnosis in Germany: An analysis based on the socio‐economic panel survey

The association of health insurance literacy and numeracy with financial toxicity and hardships among colorectal cancer survivors

Out-of-pocket payments and loss of income among long-term breast cancer survivors in Germany: a multi-regional population-based study

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