A new report finds despite reforms to the country’s health care system, many patients in China with lung cancer experience stress, and sometimes health consequences, on account of the disease’s financial burden.
Despite the rollout of universal health insurance more than a decade ago, financial toxicity remains a major issue for people in China who are diagnosed with lung cancer, according to a new study.
The report, published in Cancer Medicine, found those with advanced cancers or a poorer health status were more likely to experience financial toxicity.
Advances in cancer diagnosis and treatment have led to rising costs, and with those rising costs has come an increasing financial burden for patients, noted corresponding author Yuanli Liu, PhD, of the Chinese Academy of Medical Sciences and Peking Union Medical College. Previous research suggests that the financial burden associated with treatment can, in some cases, reach the level of toxicity, when it starts to affect patient health. For example, some patients may begin to ration medications or delay therapy due to financial concerns.
China has had a universal health care program since 2009, but Liu and colleagues said many people with lung cancer still struggle with the financial responsibilities that fall on patients. They noted that lung cancer is the most expensive cancer to treat, and its prevalence is also on the rise. In 2015, 733,300 people in China were diagnosed with lung cancer, and 610,200 people died of the disease, the authors noted.
In an effort to better understand the degree to which financial toxicity was affecting the lung cancer patient population in China, the investigators used data from a national survey to score lung cancer patients according to the comprehensive score of financial toxicity (COST) questionnaire.
In total, 843 people with lung cancer completed the questionnaire and were deemed evaluable for the study. COST scores can range from 0-44, with lower numbers indicating a higher degree of financial toxicity. Of the participants in the survey, the median toxicity score was 20. Three-quarters of patients (77%) had scores reflecting financial toxicity, with 54.5% of participants qualifying as having “mild” financial toxicity, and 22.5% having moderate or severe toxicity.
“Overall, a relatively high prevalence of [financial toxicity] in patients with lung cancer in China presents a serious challenge, with urgent attention and interventions needed,” Liu and colleagues wrote.
The investigators identified a number of factors that appeared to increase a person’s risk of experiencing financial toxicity. People in western China, which is less developed, had a higher risk of toxicity, as did men, people with a lower education level, and people of lower family income. Patients with advanced stages of lung cancer or whose self-reported health status was poor also were more likely to report financial toxicity.
The investigators said the data suggested that toxicity was, in fact, affecting patients’ medical care. Those with higher degrees of financial stress tended to be less compliant with their medical regimens, and also tended to have lower expenditures on living expenses.
“The medical compliance domain, which is related to direct negative consequences, accounted for a large proportion of patients with deteriorating [financial toxicity],” the authors wrote. “These alert for specific attention to patients with high financial risks.”
The authors said their study showed that despite “remarkable” progress at expanding the availability of health care in China, the country still must do more to lessen the burdens a lung cancer diagnosis can have on people of lower socioeconomic status.
Reference
Liu M, Huang D, Liu Y. Financial toxicity of patients with lung cancer in China: results from a National Survey Study. Cancer Med. Published online September 21, 2022. doi:10.1002/cam4.5244
Study Highlights Significant Increases in Utilization, Spending on DMD Drugs in Medicaid
May 17th 2024The findings add to recent research on the growing utilization, expenditure, and prices of Duchenne muscular dystrophy (DMD) therapies in the current landscape, an area health care policy could potentially address.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
Bleeds and Resource Use in Hemophilia B: Retrospective Observational Study
May 15th 2024This real-world US study describes individuals with hemophilia B who experience bleeds despite factor replacement therapy and quantifies the associated comorbidity and health care resource utilization burden.
Read More
A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.
Read More