Rising Gas Prices & Financial Toxicity Related to Radiation Treatment

Abstract

Radiation treatment is a time-intensive treatment with daily treatments spanning multiple weeks. The cost of transportation is rarely covered by insurance and can be a burden for patients undergoing curative treatment. In late 2022, with the rising price of gas, we set out to evaluate whether gas prices & rising costs from inflation increased financial toxicity for patients undergoing radiation treatment. A prospective survey study was developed and approved by IRB as exempt study at two sites. The survey consisted of basic demographic question and functional assessment of chronic illness therapy (FACIT) Cost measure, which was licensed for the purpose of this study. Baseline information including distance to treatment center (as measured by zip code), average cost of gas in the state, income, education level, and transportation method were also collected. Distance from treatment, average gas price, average weekly gas cost, annual household income and insurance type were dichotomized. T test and fisher exact test were used to assess the differences between groups for ordinal and binary survey questions, respectively. A p-value <0.05 was considered significant. A total of 30 complete patient questionnaires were collected between August and November 2022. When gas prices rose over $4, the percent of patients who felt in control of their financial situation was significantly decreased (p = 0.049) and percentage of patients for whom gas prices have become a burden for radiation treatment significantly increased (63.2% vs 36.8%, p<0.001), and correlated to patient's feeling of financial stress, satisfaction with their current financial situation, and perception of choice on health care spending. Travel distance >10 miles to treatment center was correlated to feeling out of pocket medical expenses to be higher than expected and ability to meet monthly expenses. Household income >$40,000 significantly increased patient's ability to meet monthly expenses (p = 0.024) and feeling of control of personal financial situation (p = 0.004) and correlated to higher satisfaction with financial stability. Type of insurance did not significantly impact financial toxicity. Only 10% of the patient knew of financial assistance while 3% utilized financial support for general medical bill and/or travel support. Rising gas prices impact patients' wellness. Rising prices are correlated to feeling more financial toxicity independent of income level. Further studies are needed to determine impact of inflation on financial toxicity. More emphasis is needed to identify high risk patients and offer more directed financial assistance.