The impact of outpatient systemic anti-cancer treatment on patient costs and work practices.

Abstract

There is extensive focus on the rising costs of healthcare. However, for patients undergoing cancer treatment, there are additional personal costs, which are poorly characterised. To qualify indirect costs during anti-cancer therapy in a designated Irish cancer centre. An anonymous questionnaire collected demographic data, current work practice, and personal expenditure on regular and non-regular indirect costs during treatment. Differences between groups of interest were compared using the Mann-Whitney U test. In total, there were 151 responders of median age 58years; 60% were female and 74% were not working. Breast cancer (29%) was the most frequent diagnosis. Indirect costs totalled a median of €1138 (range €21.60-€7089.84) per patient, with median monthly outgoings of €354. The greatest median monthly costs were hair accessories (€400), transportation (€65), and complementary therapies (€55). The majority (74%) of patients used a car and median monthly fuel expenditure was €31 (range €1.44-€463.32). Women spent more money during treatment (€1617) than men (€974, p=0.00128). In addition, median monthly expenditure was greater for those less than 50years old (€1621 vs €1105; p=0.04236), those who lived greater than 25km away (€2015 vs €1078; p=0.00008) and those without a medical card (€2023 vs €961; p=0.00024). This study highlights the need for greater awareness of indirect expenditures associated with systemic anti-cancer therapy in Ireland.