The financial burden of patients with heart disease is often greater than it is for patients with cancer, whereas individuals with both conditions suffer the highest burden, according to a study published in JACC: CardioOncology. Financial toxicity, the financial strain experienced by patients accessing health care, has been reported to impact a large population of patients with cancer in prior studies. These financial challenges can include difficulty paying medical bills or the inability to pay them at all, high financial distress, cost-related medication non-adherence, food insecurity, and delayed or foregone care due to cost.
“There is an urgent need for effective methods to alleviate financial toxicity for heart disease and cancer patients,” said Khurram Nasir, MD, MPH, MSc, in a press release. “In the current health system, there are already small- and large-scale strategies to identify and combat financial toxicity. This has already been observed among oncologists when prompted to talk to their patients about financial burden in the office. It is especially important for clinicians who care for patients with heart disease and/or cancer, given the high economic burden facing these patients.”
The study used data from the National Health Interview Survey, a nationally representative survey conducted from 2013 to 2018. The researchers reviewed 141,826 adults between 18 and 65 years of age. Of the patients reviewed, 6887 had cancer, 6093 had atherosclerotic cardiovascular disease (ASCVD), and 971 had both conditions. The investigators focused on non-elderly patients in order to capture a population without universal financial protections from public insurance, such as Medicare, although the findings reported in the Medicare population were similar.
According to the investigators, all measurements of financial toxicity were most likely to be present for patients with both ASCVD and cancer, followed in descending order by those with ASCVD, those with cancer, and those with neither condition. In particular, difficulty paying bills was significantly higher for ASCVD patients with or without cancer compared to patients with only cancer.
“Heart disease and cancer are the leading causes of death in the United States, yet most research on financial toxicity has focused on cancer patients,” Nasir said in the release. “It is important to consider that cancer patients may have short bursts of high expenditures for treatments, while heart disease patients are often incurring a more chronic economic burden due to drug costs, procedures, clinician visits and hospital stays. Also, as the rate of cancer survival grows, the population of patients with both heart disease and cancer is growing. The financial burden created by these diseases manifests as another form of affliction. Without the ability to pay, our patients can suffer from financial, health and non-health related difficulties that the health care field must be prepared to address. It does very little good if we can treat the cancer or the heart disease, but the patient can't afford to eat or pay their mortgage.”
Financial distress similar, or greater, for patients with heart disease compared to cancer [news release]. EurekAlert; June 16, 2021. Accessed June 16, 2021. https://www.eurekalert.org/pub_releases/2021-06/acoc-fds061121.php