An Observational Analysis of Financial Toxicity Inflicted on Patients and Their Family in Cancer Treatment: A Study From the Kumaon Region of India

Financial Toxicity Inflicted on Patients and Their Family in Cancer Treatment

Abstract

Background: Aim: Treatment of cancer requires multi-modality and multi-specialty care. The importance of financial toxicity inflicted on patients and their family remained under estimated. We planned to devise a tool to grade financial toxicity, which can further be used to predict expected financial toxicity in cancer treatment and subsequently make an informed, explained and unanimous decision for cancer management. Subjects and Methods: All patients diagnosed and treated for cancer with radical intension from 1st April 2012 to 31st March 2017; visiting in outdoor patients department of Swami Rama Cancer Hospital and Research Institute, Haldwani, India were asked to read and fill questionnaire, inquiring the details of their expenditure on cancer investigations, specialist consultation, purchasing drugs and undergoing procedures. Of 189 patients eligible for this study visited in outdoor patient department during 1st April 2017 to 31st March 2018; 173 patients were analyzed. Results: Of the 173 patients analyzed in the study 106 (61.3%) patients were living below poverty line. Grade I, II, III and IV financial toxicities experienced by patients were 19%, 28%, 32% and 21% respectively. There was no significant difference in financial toxicity in below poverty line or above poverty line patients. Conclusion: Financial toxicities are of the same grade irrespective of socio-economic status of patients as every patients total expenditure on cancer treatment is in accordance with their income. We can omit extremely financially toxic treatment if non-inferior and cost effective treatment is available.