Financial toxicity and its impact on health outcomes and caregiver burden among adult cancer survivors in the USA

Aim: To examine the association between cancer-related financial toxicity on cancer survivors' physical and mental health outcomes and caregiver burden. Materials & methods: 2016-2017 Medical Expenditure Panel Survey data were used to identify adult cancer survivors with cancer-related financial toxicity. Multivariable regression analyses were employed to examine the association between cancer-related financial toxicity and cancer survivors' self-reported physical and mental health outcomes and caregiver burden. Results: A total of 53.7% of adult cancer survivors reported experiencing financial toxicity. Those who experienced financial toxicity reported 14% greater pain, and poorer physical and mental health outcomes as compared to those who did not experience financial toxicity, ranging from 38% greater odds for activity limitations to 427% greater odds for mental task limitation. Moreover, cancer survivors with financial toxicity reported 206% greater odds for caregiver burden. Conclusions: Intervention programs for reducing financial toxicity among adult cancer survivors and their caregivers should be developed. Plain language summary The cost of cancer care has increased substantially over the past decade imposing significant financial burden on cancer survivors, with a growing number of cancer survivors experiencing financial toxicity. Using the Cancer Self-Administered Questionnaire of the Medical Expenditure Panel Survey, this study estimated the impact of cancer-related financial toxicity on cancer survivors' self-reported health outcomes and caregiver burden. The results highlight the impact of financial toxicity on cancer survivors' physical health and mental health outcomes and caregiver burden in a nationally representative sample of noninstitutionalized adults in the USA. The study findings document the critical need to develop interventions and implement structural policy changes aimed at identifying and reducing financial toxicity among adult cancer survivors and their caregivers.