Patient-Reported Financial Burden in Thyroid Cancer

Broekhuis, Jordan M.; Li, Chun; Chen, Hao Wei; Chaves, Natalia; Duncan, Sarah; Lopez, Betzamel; Maeda, Anthony H.; Hasselgren, Per-Olaf; Mowschenson, Peter; James, Benjamin C.

doi:10.1016/j.jss.2021.03.051

Cited by 14 publications

(38 citation statements)

References 21 publications

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“…We and others have previously found increasing age to be protective of both material and psychological financial burden in patients with cancer, and older age appears to be associated with decreased financial burden in patients with thyroid cancer as well . In a separate retrospective cohort, we have replicated these findings in a single institution and found that sizeable portions of patients with thyroid cancer lost income, incurred debt, and filed for bankruptcy owing to diagnosis and treatment . Importantly, 13 of 147 individuals (9%) reporting financial burden also reported refusing or delaying recommended thyroid cancer treatment owing to concerns about cost.…”

Section: Discussion and Observationssupporting

confidence: 70%

“…33,35 In a separate retrospective cohort, we have replicated these findings in a single institution and found that sizeable portions of patients with thyroid cancer lost income, incurred debt, and filed for bankruptcy owing to diagnosis and treatment. 34 Importantly, 13 of 147 individuals (9%) reporting financial burden also reported refusing or delaying recommended thyroid cancer treatment owing to concerns about cost. Because 37 (25%) individuals also reported feeling inadequately informed about treatment costs, delays in seeking care could represent inadequate patient education on cost considerations.…”

Section: Discussion and Observationsmentioning

confidence: 99%

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The Cost and Financial Burden of Thyroid Cancer on Patients in the US

Uppal

Lubitz

James

2022

JAMA Otolaryngol Head Neck Surg

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Section: Discussion and Observationssupporting

confidence: 70%

Section: Discussion and Observationsmentioning

confidence: 99%

The Cost and Financial Burden of Thyroid Cancer on Patients in the US

Uppal

Lubitz

James

2022

JAMA Otolaryngol Head Neck Surg

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“…This study demonstrates that the median OOPC of $2434 would likely constitute a substantial, and unexpected, financial burden for many patients. A recent study presented at the Academic Surgical Congress suggests that the psychological financial burden of thyroid cancer survivors was exacerbated by a lack of counseling or preparation for the out-of-pocket spending that these patients ultimately experienced 21…”

Section: Discussionmentioning

confidence: 99%

“…A recent study presented at the Academic Surgical Congress suggests that the psychological financial burden of thyroid cancer survivors was exacerbated by a lack of counseling or preparation for the out-of-pocket spending that these patients ultimately experienced. 21 There has been increased focus on the rising incidence of thyroid cancer in the United States and worldwide, as well as possible over-treatment of low risk thyroid cancer. 22 The findings from this study suggest that over-treatment has significant implications for financial toxicity as well.…”

Section: Discussionmentioning

confidence: 99%

Out-of-Pocket Costs for Patients Undergoing Thyroid Surgery

et al. 2021

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Objective: The aim of this study was to determine out-of-pocket costs (OOPC) in patients undergoing thyroidectomy for benign and malignant conditions in a commercially insured US population. Summary Background Data: Little is known about OOPC for thyroid surgery in the United States. Methods: Retrospective cohort study using claims of patients undergoing thyroidectomy from the IBM Watson Marketscan database from 2008 to 2017. OOPCs accrued from 90 days before surgery to 360 days after thyroid surgery were quantified. Costs were divided into expenditures for inpatient care, outpatient care and outpatient drug costs and over three time periods: from 90 days preoperatively to 30 days post operatively, from 30 days post operatively to 90 days postoperatively, and from 90 days to 1 year after surgery. Results: A total of 45,971 commercially insured patients aged 18 to 95 years who underwent thyroidectomy were identified after excluding patients who changed coverage and patients on capitated plans. The median OOPC per patient in the study period of 90 days before surgery to 360 days after surgery was $2434

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“…Current estimates of the perceived financial burden rely primarily on cohort and cross-sectional studies of thyroid cancer patients, which have shown that 46.1% of patients endorse a psychological financial burden and 28.1% of patients endorse a material financial burden ( 37 ). There is also evidence of household strain associated with thyroid cancer diagnosis and treatment on patients with 48% patients reporting reduced income, 9% losing insurance coverage as well as 18.1% reporting unemployment for at least 6 months ( 38 , 39 ). Thyroid cancer care has also been associated with adverse financial outcomes, including a higher likelihood of notice of default and foreclosure and bankruptcy compared to other cancer types ( 40 , 41 ).…”

Section: Patient-borne Financial Burden Of Thyroid Nodule Managementmentioning

confidence: 99%

Thyroid nodules: Global, economic, and personal burdens

2023

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Thyroid nodules have garnered attention due to changes in population surveillance systems and rising concerns about the associated financial burden on healthcare systems, payers, and patients. In this review, we find that prevalence rates vary widely based on method of detection and may particularly pronounced in asymptomatic patients undergoing routine screening. Incidence rates may be particularly rising in lower-income and middle-income countries and may be declining in higher-income countries. Despite high incidence rates, survival rates continue to be as high as 97% for papillary thyroid cancer. Over the last few decades, thyroid nodule workup and management has grown more sophisticated with the advent of fine-needle aspiration biopsy, specialized biomarkers, and molecular testing. However, gaps remain in risk stratification that can lead to substantial costs of care. Certain molecular tests, such as the Afirma Gene Sequencing Classifier can lead to a cost per diagnosis of $17,873 while achieving only mild decreases in diagnostic lobectomies for patients (11.6% to 9.7% in one study). Out-of-pocket costs associated with thyroid nodule management continue to drive significant financial toxicity for patients, especially for individuals with thyroid cancer. Financial toxicity has been defined as a term that describes how direct and indirect medical costs of cancer care strain patients and households via decreased income, assets, and spending on basic necessities. Recent studies suggest that such toxicity can lead to adverse financial outcomes, such as foreclosure and bankruptcy. Additional cost-effectiveness analyses are needed to improve existing thyroid nodule management systems and new clinical tools are needed to avoid unnecessary workup and management.

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Patient-Reported Financial Burden in Thyroid Cancer

Cited by 14 publications

References 21 publications

The Cost and Financial Burden of Thyroid Cancer on Patients in the US

The Cost and Financial Burden of Thyroid Cancer on Patients in the US

Out-of-Pocket Costs for Patients Undergoing Thyroid Surgery

Thyroid nodules: Global, economic, and personal burdens

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