Financial burden experienced by patients undergoing treatment for malignant gliomas: Updated data.

Abstract

e19571 Background: Patients undergoing treatment for malignant gliomas often face staggering costs beyond traditional insurance coverage. These “out-of-pocket” costs are organized into these three categories: 1) direct medical costs (e.g. hospital stays, physician visits, laboratory testing); 2) direct non-medical costs (e.g. transportation, parking, food); and 3) indirect costs (e.g. lost wages). The purpose of this study is to gain prospective data regarding monthly expenditures associated with treatment of brain tumors. Methods: Patients with stage III or IV malignant glioma within 6 months of diagnosis or relapse were eligible for this study. Weekly logbooks were issued to patients to record out-of-pocket costs during treatment for six months or until progression. Both direct medical expenses and direct non-medical expenses were measured. Results: Thirty-six patients provided an average of 12 weeks worth of cost data each. Of the patients in this sample, 59% were male, 81% were married, 50% reported annual income greater than $75,000, and the average age was 53. Mean monthly out-of-pocket costs for this population were $2,153. These monthly expenditures are higher than those measured for select other cancer populations seen in the Robert H. Lurie Comprehensive Cancer Center, including lymphoma and breast cancer patients ($1,888 and $1,455 respectively (W. S. Oatis, N. Nonzee, T. Markossian, et al. Interpreting out-of-pocket expenditures for cancer patients: The importance of considering baseline household income information. J Clin Oncol. 27:15s, 2009 (suppl; abstr 6541).) The greatest monthly costs were acquired in the form of medication co-payments ($499), transportation ($382) and hospital bills ($292). Conclusions: Out-of-pocket costs incurred by malignant glioma patients are particularly high. The treating physician must be aware of the particularly high financial burden on patients and their families undergoing treatment for malignant gliomas and work with them to minimize costs as well as understand the different expense areas. These issues are important with changes in health care coverage.