The cost of cure: Examining objective and subjective financial toxicity in head and neck cancer survivors

Baddour, Khalil; Fadel, Mark; Zhao, Meng; Corcoran, Mary; Owoc, Maryanna S.; Thomas, Teresa Hagan; Sabik, Lindsay M.; Nilsen, Marci Lee; Ferris, Robert L.; Mady, Leila J.

doi:10.1002/hed.26801

Cited by 21 publications

(55 citation statements)

References 47 publications

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“…Other work demonstrating that HNC-specific out-of-pocket expenses alone are not a predictive metric of psychologic financial hardship supports this assertion. 17 Although there is a foundational body of work examining claims data, treatment costs, and medical expenditures in patients with HNC, 9,10,12-14 the subjective implications of these financial consequences in the psychologic response domain are understudied and hence necessitate future research. Prior studies in survivors of other cancers have demonstrated that subjective indicators of financial burden such as perceived financial difficulty have a stronger impact on quality of life than direct health care costs.…”

Section: Discussionmentioning

confidence: 99%

Financial Hardship in Patients With Head and Neck Cancer

Mott

Casper

Shah

et al. 2022

JCO Oncology Practice

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PURPOSE: Financial hardship is a growing concern for patients with cancer. Patients with head and neck cancer (HNC) are particularly vulnerable, given that a third leave the workforce following treatment. The goal of our study was to characterize financial hardship in the psychologic response (response to increased expenses) and coping behaviors (behaviors patients adopt to manage their care in the setting of increased expenses) domains in patients with HNC compared with patients with other cancers. METHODS: This was a retrospective cohort study of nationally representative public survey data from 2013 to 2018 in the National Health Interviews Survey, an annual cross-sectional household survey. We included respondents age ≥ 18 years who reported a diagnosis of cancer and identified a subset of patients with HNC. Our main outcomes were financial hardship in the psychologic response and coping behaviors domains. RESULTS: Our sample included a weighted population of 357,052 patients with HNC and 21.4 million patients with other cancers. Compared with patients with other cancers, patients with HNC reported greater levels of coping behaviors hardship (31% v 23%, P = .015), but similar levels of psychologic financial hardship (73% v 72%, P = .787). Medicaid or uninsured patients more often reported coping behaviors hardship. On multivariable analysis, HNC (odds ratio, 1.51; 95% CI, 1.01 to 2.24) was independently associated with coping behaviors hardship. CONCLUSION: To our knowledge, this is the first study to evaluate financial hardship in patients with HNC compared with patients with other cancers that includes Medicaid and uninsured patients, who are more often to have financial hardship. Patients with HNC have greater levels of hardship in the coping behaviors domain compared with patients with other cancers, but similar levels in the psychologic response domain.

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Section: Discussionmentioning

confidence: 99%

Financial Hardship in Patients With Head and Neck Cancer

Mott

Casper

Shah

et al. 2022

JCO Oncology Practice

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“…11 A recent study showed an exponential association between objective and subjective financial toxicity. 12 Unlike the objective form, which can be measured with economic metrics (eg, the ratio of out-of-pocket healthcare expenditures to income), subjective financial toxicity is more challenging to assess because it involves quantifying perceptions using patient-reported outcome measures. There are generic instruments, that is, nonexclusive for cancer, that can be used to measure subjective financial toxicity in any health condition, such as the InCharge Personal Financial Well-being Scale.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis

Pangestu

Rencz²

2023

Value in Health

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“…The median annual out‐of‐pocket medical expenses for HNC patients is $8101 compared with $5930 for patients with other cancer types 27 . Expenses may continue well after HNC treatment has ended 28 . The financial toxicity may also affect patients' family caregivers 37 .…”

Section: Introductionmentioning

confidence: 99%

Health insurance literacy among head and neck cancer patients and their caregivers: A cross‐sectional pilot study

Nguyen

McCormick

Patel

et al. 2022

Laryngoscope Investig Oto

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Objective Health insurance literacy interventions may reduce financial burden and its effects on cancer patients and their caregivers. However, little is known about the health insurance literacy levels of head and neck cancer (HNC) patients and their caregivers. We assessed the feasibility of screening for health insurance literacy in a pilot study and described the health insurance literacy levels of HNC patients and their caregivers. Methods We administered a survey that assessed demographics and subjective and objective health insurance literacy to HNC patients and their caregivers. Subjective health insurance literacy was measured through the Health Insurance Literacy Measure (score range: 0–84). Objective health insurance literacy was measured through correct answers to a previously developed 10‐question knowledge test. Due to a small sample size, inferential statistics were not used; we instead descriptively reported findings. Results The pilot included 48 HNC patients and 13 caregivers. About 44.4% of patients and 30.8% of caregivers demonstrated low health insurance literacy (HILM ≤60). On the 10‐item knowledge test, patients had an average of 6.8 (SD: 2.3) correct responses and caregivers had 7.8 (SD: 1.1) correct responses. Calculating out‐of‐pocket costs for out‐of‐network services was challenging; only 9.5% of patients and 0% of caregivers answered correctly. Conclusion Additional outreach strategies may be needed to supplement screening for health insurance literacy. Areas of focus for interventions include improving understanding of how to calculate financial responsibility for health care services and filing an appeal for health insurance claim denial. Level of Evidence IV

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The cost of cure: Examining objective and subjective financial toxicity in head and neck cancer survivors

Cited by 21 publications

References 47 publications

Financial Hardship in Patients With Head and Neck Cancer

Financial Hardship in Patients With Head and Neck Cancer

Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis

Health insurance literacy among head and neck cancer patients and their caregivers: A cross‐sectional pilot study

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