Real-world evidence data (RWED) of financial toxicity (FT) in patients (pts) receiving cancer immunotherapy treatments.

Abstract

90 Background: RWED denotes data accumulated via EHR as well as cutting edge technology paired with consumer mobile devices. We are reporting data on 105 pts, users of Belong.life, a worldwide mobile application, who received immunotherapy for their various cancers and were asked to reply to a short, targeted survey on their FT while on treatment. Methods: 105 pts anonymously and voluntarily replied to a survey which included 14 general information questions and those describing FT, its most common encountered causes and their personal financial coping strategies. Results: 79% of the pts were USA based. 21% of the pts were < 50 years of age (yoa), 32% were 51-60 yoa and 47% were > 61 yoa. Pts’s stages were Stage 3 in 23% and 4 in 62% with unknown in 15%. There were 36% males and 64% females. The most common cancer diagnosis was lung in 46% followed by kidney in 17%, malignant melanoma in 14% and colorectal in 10%. The prevalent immunotherapy drugs were nivolumab and pembrolizumab in 36% respectively, and ipilimumab in 14% and durvalumab in 10%. Frequently reported FTs were high medical copayments in 35% of the pts, loss of income in 33% and high drugs and treatments copayments in 21%. 41% of the pts were insured by Medicare and 25% by Medicaid and other HMOs. Only 48% of the pts were aware of possible financial difficulties as a result of their diagnosis and treatment, and 34% received pre-treatment financial advice from their doctors which reduced the reported FT from 48% to 30%. When asked about coping strategies, 39% used personal savings, 28% trimmed their private expenses, and 24% received financial support from their families and friends. Conclusions: 105 users of the Belong.life application reported on their FTs experienced while receiving cancer immunotherapy. FT was most prevalent in the older group ( > 61 yoa) due to high medical and treatment copayments. Nearly half of the pts was not aware of the possible FT and only 38% received advisory information from their doctors. Reduced FT prevalence (from 48% to 30%) was reported by those informed pts. Physicians should become aware of their pts’s possible risks for FTs, therefore appropriate advice should be given prior to immunotherapy initiation.