QOLP-39. UNRAVELING THE TRUE COST OF CARE THROUGH ANALYSIS OF THE SOCIOECONOMIC IMPACT OF GLIOMA SURVIVORSHIP

Abstract

Abstract BACKGROUND There is a paucity of data describing the socioeconomic impact and long-term implications of glioma survivorship. Objective: To characterize the socioeconomic impact of glioma survivorship using the standardized Medical Expenditure Panel Survey – Household Component (MEPS-HC). METHODS 89 of 107 eligible adult glioma survivors that were post-treatment with stable disease were enrolled. The MEPS-HC was utilized to assess the socioeconomic hardship referable to the patient’s tumor. Comparisons between groups were evaluated using a Fisher’s exact test. RESULTS 89 patients responded to the survey (response rate = 85%, female =52%). Median follow-up from diagnosis was 6.0 years (4.3, 9.2). Pathology at diagnosis was high-grade (40%) and low-grade (60. The majority of glioma survivors were insured (91%), employed (79%), and reported annual household incomes slightly above national average. Nearly a quarter incurred debt because of their tumor (24%), 53% required extended unpaid time off, and 46% retired or were no longer working. While 85% had a Karnofsky Performance Score of > 90, the majority of respondents reported lost productivity and decreased ability to perform cognitive and physical tasks (69%). Financial burden and workforce morbidity were insensitive to tumor location, laterality, and annual household income. Patients with a gross-total resection (GTR) at initial surgery were less likely to report ongoing limitations in daily activities (45% v. 83%, p=0.004). CONCLUSIONS Despite the skewed population of high-functioning glioma survivors, financial burden and workforce morbidity was ubiquitous across all tumor subtypes, treatment paradigms, and income levels. Those with GTR were less likely to report ongoing limitations. There was a trend towards greater financial burden among those with frontal and temporal lesions.