Prospective Survey of Financial Toxicity Measured by the Comprehensive Score for Financial Toxicity in Japanese Patients With Cancer

Kazunori Honda · Bishal Gyawali · Masashi Ando · Ryosuke Kumanishi · Kyoko Kato · Keiji Sugiyama +8 more

88 citations0/0 files storedJournal of Global Oncology

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Economic and Financial Impacts of Cancer Cancer survivorship and care Food Security and Health in Diverse Populations

Abstract

PURPOSE We previously reported on the pilot study assessing the feasibility of using the Japanese translation of the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among Japanese patients with cancer. In this study, we report the results of the prospective survey assessing FT in Japanese patients with cancer using the same tool. PATIENTS AND METHODS Eligible patients were receiving chemotherapy for a solid tumor for at least 2 months. In addition to the COST survey, socioeconomic characteristics were collected by using a questionnaire and medical records. RESULTS Of the 191 patients approached, 156 (82%) responded to the questionnaire. Primary tumor sites were colorectal (n = 77; 49%), gastric (n = 39; 25%), esophageal (n = 16; 10%), thyroid (n = 9; 6%), head and neck (n = 4; 3%), and other (n = 11; 7%). Median COST score was 21 (range, 0 to 41; mean ± standard deviation, 12.1 ± 8.45), with lower COST scores indicating more severe FT. On multivariable analyses using linear regression, older age (β, 0.15 per year; 95% CI, 0.02 to 0.28; P = .02) and higher household savings (β, 8.24 per ¥15 million; 95% CI, 4.06 to 12.42; P < .001) were positively associated with COST score; nonregular employment (β, −5.37; 95% CI, −10.16 to −0.57; P = .03), retirement because of cancer (β, −5.42; 95% CI, −8.62 to −1.37; P = .009), and use of strategies to cope with the cost of cancer care (β, −5.09; 95% CI, −7.87 to −2.30; P < .001) were negatively associated with COST score. CONCLUSION Using the Japanese version of the COST tool, we identified various factors associated with FT in Japanese patients with cancer. These findings will have important implications for cancer policy planning in Japan.

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References

2013The Financial Toxicity of Cancer Treatment: A Pilot Study Assessing Out-of-Pocket Expenses and the Insured Cancer Patient's Experience 2016Measuring financial toxicity as a clinically relevant patient‐reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST)2016Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer 2018The financial burden and distress of patients with cancer: Understanding and stepping‐up action on the financial toxicity of cancer treatment 2014The development of a financial toxicity patient‐reported outcome in cancer: The COST measure 2011Japanese universal health coverage: evolution, achievements, and challenges 2016A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can’t Pay the Co-Pay 2013Are survivors who report cancer‐related financial problems more likely to forgo or delay medical care?

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