Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States
ABSTRACT Background This study investigated and compared the impact of financial toxicity (FT) on the health‐related quality of life (HRQoL) and financial well‐being of cancer patients and survivors in the United Kingdom (UK) and United States (US). Methods UK & US participants (n = 600) complet...
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| Format: | Article |
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Wiley
2025-01-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70606 |
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| author | Tran Thu Ngan Emily Tonorezos Michael Donnelly Ciaran O'Neill |
| author_facet | Tran Thu Ngan Emily Tonorezos Michael Donnelly Ciaran O'Neill |
| author_sort | Tran Thu Ngan |
| collection | DOAJ |
| description | ABSTRACT Background This study investigated and compared the impact of financial toxicity (FT) on the health‐related quality of life (HRQoL) and financial well‐being of cancer patients and survivors in the United Kingdom (UK) and United States (US). Methods UK & US participants (n = 600) completed an online questionnaire that consisted of a validated FT instrument (COmprehensive Score for financial Toxicity‐COST), a standardised HRQoL instrument (EQ‐5D‐5L) and questions related to their financial well‐being. Tobit regression models and descriptive statistics plus χ2 tests were used to analyse the association between FT and (i) HRQoL whilst controlling for sociodemographic characteristics; and (ii) financial well‐being. Results In the UK, health utilities of participants with no assessed experience of FT, mild FT, and moderate/severe FT were 0.81, 0.66, and 0.41, respectively, compared to 0.88, 0.71, and 0.53 in the US. Among those with moderate/severe FT, US participants had significantly higher health utilities compared to their peers in the UK (Mann Whitney test, p = 0.0369). In a pooled analysis of UK and US and after controlling for sociodemographic and clinical characteristics, mild and moderate/severe FT was negatively associated with health utilities (β coff = −0.13, 95% CI: −0.18, −0.08 and β coff = −0.28, 95% CI: −0.34, −0.21, respectively). Over half (54%) of US participants with FT were in debt with median (IQR) debt at I$11,500 (23,000), compared to 32% in the UK with median (IQR) debt at I$ 7200 (12,960). US participants with FT were 2.48 times more likely to be in debt than UK participants with FT (OR = 2.48, 95% CI: 1.46–4.21). Conclusions FT is associated with poorer financial well‐being and HRQoL among cancer patients/survivors in the US and UK. The impact of FT on financial well‐being is larger in the US while the impact on HRQoL is worse in the UK. Further studies using prospective data are required to investigate the nature and extent of these relationships. |
| format | Article |
| id | doaj-art-bd3bc143cf48414581274b677028ad83 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-bd3bc143cf48414581274b677028ad832025-01-24T08:46:07ZengWileyCancer Medicine2045-76342025-01-01142n/an/a10.1002/cam4.70606Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United StatesTran Thu Ngan0Emily Tonorezos1Michael Donnelly2Ciaran O'Neill3Centre for Public Health Queen's University Belfast Belfast UKOffice of Cancer Survivorship, Division of Cancer Control and Population Sciences National Cancer Institute Rockville Maryland USACentre for Public Health Queen's University Belfast Belfast UKCentre for Public Health Queen's University Belfast Belfast UKABSTRACT Background This study investigated and compared the impact of financial toxicity (FT) on the health‐related quality of life (HRQoL) and financial well‐being of cancer patients and survivors in the United Kingdom (UK) and United States (US). Methods UK & US participants (n = 600) completed an online questionnaire that consisted of a validated FT instrument (COmprehensive Score for financial Toxicity‐COST), a standardised HRQoL instrument (EQ‐5D‐5L) and questions related to their financial well‐being. Tobit regression models and descriptive statistics plus χ2 tests were used to analyse the association between FT and (i) HRQoL whilst controlling for sociodemographic characteristics; and (ii) financial well‐being. Results In the UK, health utilities of participants with no assessed experience of FT, mild FT, and moderate/severe FT were 0.81, 0.66, and 0.41, respectively, compared to 0.88, 0.71, and 0.53 in the US. Among those with moderate/severe FT, US participants had significantly higher health utilities compared to their peers in the UK (Mann Whitney test, p = 0.0369). In a pooled analysis of UK and US and after controlling for sociodemographic and clinical characteristics, mild and moderate/severe FT was negatively associated with health utilities (β coff = −0.13, 95% CI: −0.18, −0.08 and β coff = −0.28, 95% CI: −0.34, −0.21, respectively). Over half (54%) of US participants with FT were in debt with median (IQR) debt at I$11,500 (23,000), compared to 32% in the UK with median (IQR) debt at I$ 7200 (12,960). US participants with FT were 2.48 times more likely to be in debt than UK participants with FT (OR = 2.48, 95% CI: 1.46–4.21). Conclusions FT is associated with poorer financial well‐being and HRQoL among cancer patients/survivors in the US and UK. The impact of FT on financial well‐being is larger in the US while the impact on HRQoL is worse in the UK. Further studies using prospective data are required to investigate the nature and extent of these relationships.https://doi.org/10.1002/cam4.70606cancercancer survivorshipEQ‐5D‐5Lfinancial toxicityhealth‐related quality of life |
| spellingShingle | Tran Thu Ngan Emily Tonorezos Michael Donnelly Ciaran O'Neill Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States Cancer Medicine cancer cancer survivorship EQ‐5D‐5L financial toxicity health‐related quality of life |
| title | Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States |
| title_full | Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States |
| title_fullStr | Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States |
| title_full_unstemmed | Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States |
| title_short | Impact of Financial Toxicity on the Health‐Related Quality of Life and Financial Well‐Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States |
| title_sort | impact of financial toxicity on the health related quality of life and financial well being of cancer patients and survivors a comparative study of the united kingdom and united states |
| topic | cancer cancer survivorship EQ‐5D‐5L financial toxicity health‐related quality of life |
| url | https://doi.org/10.1002/cam4.70606 |
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