Financial toxicity describes duress from financial strain due to treatment or disease burden, often impacting outcomes. Head and neck cancer (HNC) patients are at higher risk of financial toxicity (FT) and worse oncologic outcomes regardless of insurance status. To address this and improve our understanding, we look to describe patient experiences with treatment-related financial burden and elucidate mechanisms underlying FT in HNC survivorship. We used a prospective dyadic cohort study of treatment-naïve HNC patients and their primary informal caregivers performed from October 2019-December 2020 at a single, tertiary academic center conducting semi-strucutred intereviews. Caretakers if present, were included in the interviews.
Of 74 eligible patients, 41 were interviewed. A range of experiences were reported (Table 1), with most describing high out-of-pocket expenses (OOPE) such as uncovered dental costs, challenges from indirect opportunity costs, such as lost wages and parking, impacts on medical services, and effects on life activities. Narratives from survivors and their caregivers provide insight into mechanisms by which the direct and indirect costs of cancer care impact HNC patient employment, financial coping behaviors, and ultimately quality of care. Our findings highlight patient-identified needs that may be targeted for interventions aimed at reducing FT, such as early financial navigation from the time of diagnosis, revising dental coverage policies, and eliminating unsupported logistical costs.
Ebbott, David, "Financial Toxicity in Head and Neck Cancer Survivorship: The Patient Perspective" (2023). Master of Public Health Capstone Presentations. Presentation 484.