Abstract A001: Financial toxicity and social needs in patients with ovarian cancer: a multi-practice survey

Abstract

Abstract Background: Treatment of ovarian cancer often involves expensive, sequential treatments, such as chemotherapy and surgery followed by long-term maintenance therapy. The direct and indirect costs of these treatments may create a significant financial burden and new care needs for patients. Our objective was to characterize financial toxicity and social needs in patients with ovarian cancer seen in a multi-practice health system. Methods: Patients in the University of Pennsylvania gynecologic oncology practices from January 2020 to February 2022 who had a patient portal account (n=6,925) were surveyed twice between March and April 2022, on financial toxicity. Those with ovarian cancer were included in this study. The survey included the 11-item Comprehensive Score for Financial Toxicity (COST) tool and a social needs question, “What service would be of most benefit to you in reducing financial toxicity of your treatment?” Responses were categorized as: very important; important; slightly important; and not at all important. We defined responses of “very important” and “important” as meeting high social need. Chi-squared and z-tests were used to compare differences between patients reporting high (COST< 26) and low (COST ≥26) financial toxicity. Results: 111 of 498 survey respondents identified as having ovarian cancer. The median COST score was 29 (range 6-44). 39% (n=37) had high financial toxicity, and 7% (7) had severe financial toxicity (COST<14). 19%(18) described their ovarian cancer as causing financial hardship to them and their family. 48% (26) of patients with private insurance and 48% (25) of patients under age 65 experienced high financial toxicity. Patients with private insurance were more likely to experience high financial toxicity (p=0.03) compared to patients with Medicare. Younger patients were more likely to experience high financial toxicity (p<0.001). Patients who were unemployed were more likely to experience high financial toxicity than those who were employed (p<0.001). Patients reported assistance with indirect costs of care (e.g., lost work) would be the most helpful in reducing financial toxicity (36%, 38) followed by assistance with out-of-pocket costs (29%, 31); housing and heating costs (27%, 28); and transportation (22%, 23). Conclusions: In a multi-practice survey, 39% of patients with ovarian cancer experienced financial toxicity, and 19% experienced financial hardship due to their cancer. Half of patients under age 65 and half of privately insured patients experienced financial toxicity. Patients identified assistance with direct and indirect costs of care (e.g., lost work, out-of-pocket costs) as the most helpful interventions. Interventions to address social needs and reduce financial toxicity are needed for patients with ovarian cancer. Citation Format: Anna Jo B. Smith, Maya H. Sharma, Kristina Powell, Meredith Doherty, Stefanie N. Hinkle, Emily M. Ko. Financial toxicity and social needs in patients with ovarian cancer: a multi-practice survey [abstract]. In: Proceedings of the AACR Special Conference on Ovarian Cancer; 2023 Oct 5-7; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_2):Abstract nr A001.