Abstract
Background and ObjectivePsychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer. They contribute to the overall economic burden of cancer that patients experience. But this category of costs remains poorly understood. This hinders opportunities to make the best cancer control policy decisions. This study explored the psychosocial cost burden associated with cancer, how studies measure psychosocial costs and the impact of this burden.MethodsA systematic literature review of academic and grey literature published from 2008 to 2018 was conducted by searching electronic databases, guided by the Institute of Medicine’s conceptualization of psychosocial burden. Results were analyzed using a narrative synthesis and a weighted proportion of populations affected was calculated. Study quality was assessed using the Ottawa‐Newcastle instrument.ResultsA total of 25 studies were included. There was variation in how psychosocial costs were conceptualized and an inconsistent approach to measurement. Most studies measured social dimensions and focused on the financial consequences of paying for care. Fewer studies assessed costs associated with the other domains of this burden, including psychological, physical, and spiritual dimensions. Fourty‐four percent of cancer populations studied were impacted by psychosocial costs and this varied by disease site (38%‐71%). Two studies monetized the psychosocial cost burden, estimating a lifetime cost per case ranging from CAD$427753 to CAD$528769. Studies were of varying quality; 60% of cross‐sectional studies had a high risk of bias.ConclusionsConsistency in approach to measurement would help to elevate this issue for researchers and decision makers. At two‐thirds of the total economic burden of cancer, economic evaluations should account for psychosocial costs to better inform decision‐making. More support is needed to address the psychosocial cost burden faced by patients and their families.
Highlights
The rising costs of cancer treatment and supportive care[1] are a concern for health care systems, patients, and their families
As most studies were conducted in the United States, where the majority of individuals are not covered under a publicly funded health insurance system and often face significant out-ofpocket costs associated with cancer, we looked at the prevalence of the cost burden in non-US studies and found the estimates ranged between 32%30 and 47%27 for the studies conducted in Ireland
The estimated lifetime costs of the psychosocial burden were approximately CDN $428689 using conservative measures, representing two-thirds of the total economic burden associated with a cancer diagnosis
Summary
The rising costs of cancer treatment and supportive care[1] are a concern for health care systems, patients, and their families. Due to the large economic burden of cancer care, it is important to have an accurate estimate of the costs associated with cancer and a good understanding of who bears those costs.[2] Cost-of-illness studies can help translate the adverse effects of diseases into dollars, which is one input to support decision-making. This information is crucial to help set future health budgets, to help aid in the allocation of scarce resources and, supports decision-making for cancer control systems. Psychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer They contribute to the overall economic burden of cancer that patients experience.
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