Financial Toxicity: Measuring its height by the Shade it Casts

Jonas de Souza was one of four speakers in the financial toxicity forum at this years’ Bladder Cancer Advocacy Network meeting. He gave an excellent evidence-based presentation regarding Financial Toxicity and it’s Burden.  

Dr. de Souza defines financial toxicity based upon how the cost of treatment affects the patients’ quality of life. He recognizes that cost-sharing is increased over past 30 years and a change in distribution of health plan enrollment has affected patients. He quoted that bankruptcy in cancer patients is linked to survival. He is is trying to answer key questions such as defining how financial toxicity affects Quality of Life, Grading financial toxicity on how it affect your life, and adverse events from financial toxicity. 

As a result he has worked on the Development of a Financial Toxicity Patient Reported Outcome measure using a FACT – QOL based questionnaire on finance, the Comprehensive Score for Financial Toxicity (COST-PROM),  (de Souza et al., 2014). It is an 11-item measure that is a patient-centered, scientifically directed outcome measure for financial toxicity.

His research thus far has opened the door for further assessment of financial toxicity and has allowed it to be incorporated into clinical trials as an objective outcome measure. He describes future directions that include use of an ICD10 code for financial toxicity, and more post- marketing analysis on efficacy and cost of certain drug treatments. 

Presented By: Jonas de Souza, MD University of Chicago

Written by: Michael J Metcalfe, MD. Fellow of Urologic Oncology Urology, MD Anderson Cancer Center, Houston TX.  

Ashish M. Kamat, MD, MBBS, FACS
President, International Bladder Cancer Network
Chair, Society of Immunotherapy for Cancer (SITC), BCTF
Director of Urologic Oncology Fellowship
Professor of Urology
Attending Surgeon, Division of Surgery
The University of Texas, MD Anderson Cancer Center

de Souza, J. A., Yap, B. J., Hlubocky, F. J., Wroblewski, K., Ratain, M. J., Cella, D., & Daugherty, C. K. (2014). The development of a financial toxicity patient-reported outcome in cancer: The COST measure. Cancer, 120(20), 3245-3253. doi: 10.1002/cncr.28814

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