Finance toxicity measures how out-of-pocket costs of treatment can impact patients material conditions such as medical debt and bankruptcy, results in financial worry and coping behaviors such as non-adherence to care and lifestyle changes to offset costs. MS patients specifically face considerable financial hardship due to the expensive treatments, high rates of disability and lost income.
“Over the last 20 years, higher out-of-pocket costs for advanced imaging tests and increased cost sharing have caused the financial burdens on MS patients to escalate. Among medically bankrupt families, MS is associated with the highest total out of-pocket expenditures exceeding those of cancer patients,” said lead author Gelareh Sadigh, MD, assistant radiology professor at Emory University School of Medicine. “Our study results demonstrate the high prevalence of financial toxicity for MS patients and the resulting decisions patients make that impact their health care and lifestyle.”
Dr. Sadigh and team surveyed 243 adult MS patients visiting neurology clinics. Overall, 56% of patients reported decreases in income after their MS diagnosis, with 37% experiencing a decrease greater than 20%. In response to care non-adherence, 35% reported medication or imaging non-adherence due to treatment expenses with 13% reporting non-receipt of recommended imaging tests, which have higher copayments than other health care services.1
“These data underscore the need for shared decision-making and an awareness of patient financial strain when planning treatment strategies,” said co-author and Neiman Institute affiliate senior research fellow, Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University . “In addition to the impact on adherence, financial toxicity was associated with significantly lower physical health-related quality of life (HRQOL), demonstrating the broad consequences of treatment costs for many MS patients.”
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[1] Rosenkrantz, AB, Sadigh, G, Carlos, RC, Silva, E, and Duszak, R. Out-of-Pocket Costs for Advanced Imaging Across the US Private Insurance Marketplace. J Am Coll Radiol 2018;15:607-614.