Abstract
GoalTo determine patient-reported financial and family burden associated with treatment of cancer in the previous 28 days across Canada.MethodsA self-administered questionnaire (P-SAFE v7.2.4) was completed by 901 patients with cancer from twenty cancer centres nationally (344 breast, 183 colorectal, 158 lung, 216 prostate) measuring direct and indirect costs related to cancer treatment and foregone care. Monthly self-reported out-of-pocket-costs (OOPCs) included drugs, homecare, homemaking, complementary/ alternative medicines, vitamins/supplements, family care, accommodations, devices, and “other” costs. Travel and parking costs were captured separately. Patients indicated if OOPC, travel, parking, and lost income were a financial burden.ResultsMean 28-day OOPCs were CA$518 (US Purchase Price Parity [PPP] $416), plus CA$179 (US PPP $144) for travel and CA$84 (US PPP $67) for parking. Patients self-reporting high financial burden had total OOPCs (33%), of CA$961 (US PPP $772), while low-burden participants (66%) had OOPCs of CA$300 (US PPP $241). “Worst burden” respondents spent a mean of 50.7% of their monthly income on OOPCs (median 20.8%). Among the 29.4% who took time off work, patients averaged 18.0 days off. Among the 26.0% of patients whose caregivers took time off work, caregivers averaged 11.5 days off. Lastly, 41% of all patients had to reduce spending. Fifty-two per cent of those who reduced spending were families earning < CA$50,000/year.ConclusionsIn our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes.
Highlights
In our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes
Cancer treatment consumes significant public and private expenditures, with the most recent published direct medical costs for cancer care in Canada estimated at CA$7.5 billion for 2012 [1]
The P-SAFE v7.2.4 questionnaire is a comprehensive measure including 31 questions, some with multiple parts. It includes details on patient demographics, general health, duration of current cancer treatment, current treatments received, level of insurance coverage, employment details, out-of-pocket costs (OOPCs), perceived financial burden, decisions to forego care, and time lost from work for patients and their caregivers
Summary
In our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes.
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