PD25-03 THE INCIDENCE AND PREDICTORS OF FINANCIAL TOXICITY IN A PROSPECTIVE COHORT OF PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures II (PD25)1 Sep 2021PD25-03 THE INCIDENCE AND PREDICTORS OF FINANCIAL TOXICITY IN A PROSPECTIVE COHORT OF PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER Vidit Sharma, Katherine E Fero, Patrick M Lec, Valerie S Lee, Isaac J Ergas, Janise M Roh, Karim Chamie, Mark Schoenberg, David S Aaronson, Devon K Check, Reina Haque, Lawrence H Kushi, Li Tang, and Marilyn L Kwan Vidit SharmaVidit Sharma More articles by this author , Katherine E FeroKatherine E Fero More articles by this author , Patrick M LecPatrick M Lec More articles by this author , Valerie S LeeValerie S Lee More articles by this author , Isaac J ErgasIsaac J Ergas More articles by this author , Janise M RohJanise M Roh More articles by this author , Karim ChamieKarim Chamie More articles by this author , Mark SchoenbergMark Schoenberg More articles by this author , David S AaronsonDavid S Aaronson More articles by this author , Devon K CheckDevon K Check More articles by this author , Reina HaqueReina Haque More articles by this author , Lawrence H KushiLawrence H Kushi More articles by this author , Li TangLi Tang More articles by this author , and Marilyn L KwanMarilyn L Kwan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002018.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Even though non-muscle invasive bladder cancer (NMIBC) has high costs care, the patient-level impact of this cost (“financial toxicity”) has been understudied. We describe predictors and quality-of-life (QOL) implications of financial toxicity in a prospective cohort of NMIBC survivors. METHODS: The Bladder Cancer Epidemiology, Wellness, and Lifestyle Study is a prospective cohort of newly diagnosed NMIBC patients at Kaiser Permanente Northern and Southern California. Financial toxicity was assessed using the COST-FACIT questionnaire (scale 0 to 44, with lower score having more financial toxicity) at 2-years post-diagnosis. QOL was assessed using the PROMIS global health questionnaire’s physical and mental health domains at 2-years post-diagnosis. Demographic and oncologic associations with financial toxicity were examined using descriptive statistics and multivariable generalized linear regression models. RESULTS: In a cohort of 412 participants, the mean (SD) COST and PROMIS physical and mental health QOL scores at 2-years post-diagnosis were: 36.6 (7.3), 16.2 (2.3), 15.4 (2.7), respectively. The correlation between the COST and PROMIS physical and mental health scores was r=0.36 (p<0.01) and r=0.38 (p<0.01), respectively, suggesting a modest association between financial toxicity and QOL. Between 4–16% of participants reported some financial strain from NMIBC on specific COST questions (Figure 1). At 2-years, 5% of patients described the financial burden of NMIBC as being significant, and 2% of patients experienced financial distress from treating their cancer. On regression analysis, younger age (coefficient -0.12, p<0.01) and NMIBC progression (coefficient -2.9, p=0.04) were associated with increased financial toxicity (reduced COST score). Gender or race/ethnicity were not significantly associated with financial toxicity. CONCLUSIONS: In a vertically integrated health system, financial toxicity from NMIBC was less prevalent than reported in prior studies in conventional health systems. However, younger age and NMIBC progression were associated with increased financial toxicity, suggesting a need to identify mitigation strategies for such patients. Source of Funding: Vidit Sharma is supported by the VA HSRD fellowship © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e432-e432 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vidit Sharma More articles by this author Katherine E Fero More articles by this author Patrick M Lec More articles by this author Valerie S Lee More articles by this author Isaac J Ergas More articles by this author Janise M Roh More articles by this author Karim Chamie More articles by this author Mark Schoenberg More articles by this author David S Aaronson More articles by this author Devon K Check More articles by this author Reina Haque More articles by this author Lawrence H Kushi More articles by this author Li Tang More articles by this author Marilyn L Kwan More articles by this author Expand All Advertisement Loading ...