1872P - Financial distress of a cancer disease in Germany: A new patient reported outcome measure (PROM) and first results from a bi-centered cross-sectional analysis

Background

Individual financial distress (FD) of a cancer disease impacts patient’s health-related quality of life. FD also occurs in countries with universal healthcare coverage, but comprehensive data about the extent is lacking. We have developed a new standardized PROM for FD in Germany based on qualitative pre-studies (patients/social services representatives) and a literature review. The validity of the PROM is tested in two survey waves including at least n=400 cancer patients. This study aims to determine the degree of FD in cancer patients using the PROM.

Methods

A bi-centered cross-sectional study was performed including n=112 cancer patients; the PROM was administered between June/ July 2022 in outpatient units, ambulances or oncological wards of two university hospitals in Germany. Patients were eligible if they had confirmed solid cancer (ECOG-Status <2) and had undergone >2 months of therapy. A MANOVA was performed to analyze the dimensions of FD.

Results

88.3 percent of patients reported higher (non-)medical costs due to cancer disease in the last six month, spending on average 400€ per month. 65.1 percent of patients experienced a loss of income (p<.001), so that the average monthly income changed from 2000-2499€ (M: 4.39; SD: 2.82) to 1500-1999€ (M: 3.17; SD: 2.19). Most patients cope with changes by gaining an overview of their financial situation, being frugal or adopting a relaxed attitude to their financial situation. Perceived FD is mainly attributed to difficulties in maintaining a healthy lifestyle and housing. Female gender, living alone and a low income are significantly associated with higher FD. There are no significant differences in age, education level, occupational status, type of insurance and time since cancer diagnosis.

Conclusions

FD is a common phenomenon that also occurs in countries like Germany. It is driven by rising direct (non-) medical costs and income losses due to diagnosis and treatment. In the next step, we validate the PROM in a second larger sample with n=400 participants and verify our initial findings of FD. There is a need to comprehensively measure FD using a validated PROM to determine the effects on health outcomes and to derive targeted support.

Clinical trial identification

NCT05319925.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

German Cancer Aid.

Disclosure

All authors have declared no conflicts of interest.