Comparison between real costs and patient's perceptions of the chemotherapy in a Brazilian cancer care facility.

Abstract

e18343 Background: Cancer is growing very fast and is responsible for roughly 7 million deaths annually. Cancer patients throughout the world suffer from both psychosocial and financial distress early in the time they are diagnosed with the disease. While anti-cancer therapy can magnify such effects by consuming extra intellectual energy from the patient and their family, further burden derived from the economic implications of cancer treatment have been ranked by many as an urgent issue. Methods: 46 patients with diagnosis of prostate, breast, lung or gastrintestinal cancer were asked to fill out a form while receiving chemotherapy. It contained 14 questions. Nurses were responsible for data collection. Wilcoxon test was used to test for interaction. Results: The mean age of patients was 62.2 (±13) and 58% of them were women. Aproximately half of them declared having completed higher education or more. The majority of patients had breast cancer (40%) followed by colorectal (38%), prostate (16%) and lung (5%). Most of the patients believed to be treating a localized disease and thought cure was their treatment goal. 31% of patients said they spent more than expected with their treatment and nearly half thought cost to be a concern. When reviewing patient's expectations and real treatment goals we noticed that the majority of patients had stage IV disease (56%) and that 60% were under palliative care. The median actual cost declared by patients was R$3,000 while the real cost median was R$7,055 which accounts for a 40% downstaging of the real cost. At last, 78% of patients estimated the costs to be less than it really is. Conclusions: There is still a large gap between patient's perceptions about chemotherapy goals and disease stage. When it comes to costs of the treatment the majority of patients tend to underestimate it. That may be in part because most brazilian private health care providers do not work with co-participation and therefore all costs are covered.