Patient and family financial burden associated with cancer treatment in Canada: a national study

Christopher J Longo^{1

2}, Margaret I Fitch³, Jonathan M Loree⁴, Linda E Carlson⁵, Donna Turner⁶, Winson Y Cheung⁷, Darin Gopaul⁸, Janet Ellis⁹, Jolie Ringash¹⁰, Maria Mathews¹¹, Jim Wright¹², Christiaan Stevens¹³, David D'Souza¹⁴, Robin Urquhart¹⁵, Tuhin Maity¹⁶, Fanor Balderrama¹⁷, Evette Haddad¹⁶

Affiliations

¹ DeGroote School of Business-Health Policy & Management, McMaster University, 4350 South Service Rd, Burlington, Ontario, L7L 5R8, Canada. clongo@mcmaster.ca.
² Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. clongo@mcmaster.ca.
³ Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, M4C 4V9, Canada.
⁴ Department of Medicine, Division of Medical Oncology, BC Cancer / University of British Columbia, 600 West 10th Avenue, Vancouver, British Columbia, V5Z4E6, Canada.
⁵ Department of Oncology, Cummings School of Medicine, University of Calgary, 2202 2nd St SW, Calgary, Alberta, T2S 3C1, Canada.
⁶ Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada.
⁷ Department of Oncology, University of Calgary, 1331-29 Street NW, Calgary, Alberta, T2N 4N2, Canada.
⁸ Grand River Regional Cancer Centre, Kitchener, Ontario, N2G 1G3, Canada.
⁹ Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
¹⁰ Princess Margaret Cancer Centre/UHN, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada.
¹¹ Department of Family Medicine, Western University, London, Ontario, Canada.
¹² Juravinski Cancer Centre, McMaster University, Hamilton, Canada.
¹³ Department of Radiation Oncology, University of Toronto, Barrie, Ontario, L4M 6M2, Canada.
¹⁴ London Health Sciences Centre, Western University, London, Ontario, Canada.
¹⁵ Department of Surgery, Dalhousie University, Room 8-032, Centennial Building, 1276 South Park St., Halifax, Nova Scotia, B3H 2Y9, Canada.
¹⁶ DeGroote School of Business-Health Policy & Management, McMaster University, 4350 South Service Rd, Burlington, Ontario, L7L 5R8, Canada.
¹⁷ Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.

PMID: 33403399
PMCID: PMC8062343
DOI: 10.1007/s00520-020-05907-x

Patient and family financial burden associated with cancer treatment in Canada: a national study

Christopher J Longo et al. Support Care Cancer. 2021 Jun.

. 2021 Jun;29(6):3377-3386.

doi: 10.1007/s00520-020-05907-x. Epub 2021 Jan 5.

Authors

Affiliations

¹ DeGroote School of Business-Health Policy & Management, McMaster University, 4350 South Service Rd, Burlington, Ontario, L7L 5R8, Canada. clongo@mcmaster.ca.
² Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. clongo@mcmaster.ca.
³ Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, M4C 4V9, Canada.
⁴ Department of Medicine, Division of Medical Oncology, BC Cancer / University of British Columbia, 600 West 10th Avenue, Vancouver, British Columbia, V5Z4E6, Canada.
⁵ Department of Oncology, Cummings School of Medicine, University of Calgary, 2202 2nd St SW, Calgary, Alberta, T2S 3C1, Canada.
⁶ Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada.
⁷ Department of Oncology, University of Calgary, 1331-29 Street NW, Calgary, Alberta, T2N 4N2, Canada.
⁸ Grand River Regional Cancer Centre, Kitchener, Ontario, N2G 1G3, Canada.
⁹ Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
¹⁰ Princess Margaret Cancer Centre/UHN, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada.
¹¹ Department of Family Medicine, Western University, London, Ontario, Canada.
¹² Juravinski Cancer Centre, McMaster University, Hamilton, Canada.
¹³ Department of Radiation Oncology, University of Toronto, Barrie, Ontario, L4M 6M2, Canada.
¹⁴ London Health Sciences Centre, Western University, London, Ontario, Canada.
¹⁵ Department of Surgery, Dalhousie University, Room 8-032, Centennial Building, 1276 South Park St., Halifax, Nova Scotia, B3H 2Y9, Canada.
¹⁶ DeGroote School of Business-Health Policy & Management, McMaster University, 4350 South Service Rd, Burlington, Ontario, L7L 5R8, Canada.
¹⁷ Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.

PMID: 33403399
PMCID: PMC8062343
DOI: 10.1007/s00520-020-05907-x

Erratum in

Correction to: Patient and family financial burden associated with cancer treatment in Canada: a national study.
Longo CJ, Fitch MI, Loree JM, Carlson LE, Turner D, Cheung WY, Gopaul D, Ellis J, Ringash J, Mathews M, Wright J, Stevens C, D'Souza D, Urquhart R, Maity T, Balderrama F, Haddad E. Longo CJ, et al. Support Care Cancer. 2021 Jun;29(6):3387-3388. doi: 10.1007/s00520-021-06031-0. Support Care Cancer. 2021. PMID: 33587175 Free PMC article. No abstract available.

Abstract

Goal: To determine patient-reported financial and family burden associated with treatment of cancer in the previous 28 days across Canada.

Methods: A self-administered questionnaire (P-SAFE v7.2.4) was completed by 901 patients with cancer from twenty cancer centres nationally (344 breast, 183 colorectal, 158 lung, 216 prostate) measuring direct and indirect costs related to cancer treatment and foregone care. Monthly self-reported out-of-pocket-costs (OOPCs) included drugs, homecare, homemaking, complementary/ alternative medicines, vitamins/supplements, family care, accommodations, devices, and "other" costs. Travel and parking costs were captured separately. Patients indicated if OOPC, travel, parking, and lost income were a financial burden.

Results: Mean 28-day OOPCs were CA$518 (US Purchase Price Parity [PPP] $416), plus CA$179 (US PPP $144) for travel and CA$84 (US PPP $67) for parking. Patients self-reporting high financial burden had total OOPCs (33%), of CA$961 (US PPP $772), while low-burden participants (66%) had OOPCs of CA$300 (US PPP $241). "Worst burden" respondents spent a mean of 50.7% of their monthly income on OOPCs (median 20.8%). Among the 29.4% who took time off work, patients averaged 18.0 days off. Among the 26.0% of patients whose caregivers took time off work, caregivers averaged 11.5 days off. Lastly, 41% of all patients had to reduce spending. Fifty-two per cent of those who reduced spending were families earning < CA$50,000/year.

Conclusions: In our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes.

Keywords: Cancer; Financial burden; Financial toxicity; Out-of-pocket costs; Self-administered questionnaire.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

References

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Patient and family financial burden associated with cancer treatment in Canada: a national study

Affiliations

Patient and family financial burden associated with cancer treatment in Canada: a national study

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical