Abstract
BackgroundFinancial toxicity (FT) has a negative impact on the quality of life and survival of patients with cancer. The comprehensive score for FT (COST) questionnaire is a tool to measure FT which has already been validated in patients with cancer in the United States. However, the feasibility and validity of assessing FT using the COST questionnaire have not been established in non-US healthcare settings, including that in Japan.MethodsThis is a prospective pilot survey to ascertain the feasibility of using the COST questionnaire to evaluate FT in Japanese patients with advanced solid cancer who had been receiving chemotherapy for at least 2 months. The COST questionnaire was translated into Japanese using Functional Assessment of Chronic Illness Therapy methodology.ResultsOf the 12 patients approached, 11 (92%) responded to the questionnaire. The median COST score was 22 (range, 6–29; mean ± SD, 20.18 ± 8.17). Five (45%) and two (18%) patients suffered grade 1 (COST score 14–25) and grade 2 (COST score 1–13) FT, respectively. The COST measure demonstrated good internal consistency with a Cronbach α of 0.87.ConclusionsThe COST measure demonstrated good feasibility in measuring FT in the Japanese healthcare setting. Despite the existing universal health insurance system and ceiling amount for high-cost medical expenses, some Japanese patients experienced meaningful FT during chemotherapy. A prospective study is already underway to confirm the preliminary results (UMIN: 000025043).
Highlights
Financial toxicity (FT) is a well-recognised problem in cancer care [1]
A study done in Italy, which has a universal health insurance system similar to that of Japan, has shown that FT is associated with poor survival [7]
Our study showed that it was feasible to use the comprehensive score for FT (COST) tool to measure FT among Japanese cancer patients, with high response rate and internal consistency measured by Cronbach α
Summary
Financial toxicity (FT) is a well-recognised problem in cancer care [1]. FT refers to the increased financial burden on cancer patients to cover the costs of treatment which adversely affects the patient’s lifestyle. A study done in Italy, which has a universal health insurance system similar to that of Japan, has shown that FT is associated with poor survival [7]. The comprehensive score for FT (COST) questionnaire is a tool to measure FT which has already been validated in patients with cancer in the United States. The feasibility and validity of assessing FT using the COST questionnaire have not been established in non-US healthcare settings, including that in Japan. Methods: This is a prospective pilot survey to ascertain the feasibility of using the COST questionnaire to evaluate FT in Japanese patients with advanced solid cancer who had been receiving chemotherapy for at least 2 months.
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