Out‐of‐pocket costs and burden among rural breast cancer survivors

Abstract

Little is known about out‐of‐pocket (OOP) costs incurred for medical and health needs by rural breast cancer survivors and what factors may be associated with higher OOP costs and the associated economic burden. Data were examined for 432 survivors participating in the Rural Breast Cancer Survivor Intervention trial. OOP costs were collected using the Work and Finances Inventory survey at baseline and four assessments every 3 months. Mean and median OOP costs and burden (percent of monthly income spent on OOP costs) were reported and factors associated with OOP costs and burden identified with generalized linear models fitted with over‐dispersed gamma distributions and logarithmic links (OOP costs) and with beta distributions with logit link (OOP burden). OOP costs per month since the end of treatment were on average $232.7 (median $95.6), declined at the next assessment point to $186.5 (median $89.1), and thereafter remained at that level. Mean OOP burden was 9% at baseline and between 7% and 8% at the next assessments. Factors suggestive of contributing to higher OOP costs and OOP burden were the following: younger age, lower income, time in survivorship from diagnosis, and use of supportive services. OOP costs burden rural breast cancer survivors, particularly those who are younger and low income. Research should investigate the impact of OOP costs and interventions to reduce economic burden.

Costs of cancer along the care continuum: What we can expect based on recent literature

“…Table summarizes the costs of adult cancer survivors from household survey‐based studies . Guy et al reported annual costs to all payers of $17,170 for recently diagnosed survivors and considerably lower costs for longer term survivors, although these were still higher than the costs among those without a history of cancer (Table ) .…”

“…Costs of medical care, including transportation costs, ranged from $129 to $149 per month over 1 year . Survivors also reported costs of counseling and health maintenance ranging from $88 to $167 per month, costs of side‐effect management ranging from $38 to $59 per month, and costs for home maintenance ranging from $138 to $186 …”

Most impactful factors on the health‐related quality of life of a geriatric population with cancer

“…). Financial hardship, measured with 9 Work and Finances Inventory items such as filing for bankruptcy or losing savings due to cancer, was the number of these items experienced during the previous 6 months. Challenges in accessing care were assessed with questions adapted from the Medical Expenditure Panel Survey to determine whether respondents were unable to or were delayed in obtaining medical care, tests, treatments, or prescription medications within the previous 6 months.…”

‘It was a big monetary cut’—A qualitative study on financial toxicity analysing patients’ experiences with cancer costs in Germany

“…In addition to a deeper understanding of the costs that induce financial toxicity, identifying high‐risk patients is important (Carrera et al, ). Medical and non‐medical out‐of‐pocket costs have been found to be higher for patients with, for example, younger age, higher household income and longer distance from treatment centres (Baili et al, ; Davidoff et al, ; Newton et al, ; Pisu, Azuero, Benz, McNees, & Meneses, ; Valtorta & Hanratty, ). Furthermore, studies have found that low socioeconomic status is a risk factor for unemployment after a cancer diagnosis; for women, a cancer diagnosis results in a higher risk of unemployment, but mainly male cancer patients seem to be affected by a total decline in family income (Torp, Nielsen, Fosså, Gudbergsson, & Dahl, ; Zajacova et al, ).…”