Financial Toxicity
Financial toxicity is a relatively new term for a familiar but insufficiently examined phenomenon in the treatment and care of people with cancer. The term refers to the unintended and possibly unanticipated objective financial burden and subjective financial distress experienced by cancer patients resulting from treatment. Akin to physical toxicity, financial toxicity from both actual and potential out-of-pocket expenditures associated with cancer care especially regarding chemotherapy can diminish quality of life, impede delivery of the highest quality care, and worsen outcomes. As such, quality supportive care requires addressing the financial toxicity of cancer treatment. Unlike physical toxicity, the financial burden of treatment is not borne by the cancer patient alone but by the household of the individual and may be externalized. In this regard, patient preferences for and adherence to cancer treatment may be influenced by considerations regarding the impact of financial toxicity on household welfare. Strategies for dealing with financial toxicity vary by the individual and health system with some systems collectivizing and assuming the bulk of costs of cancer treatment resulting in low out-of-pocket expenditures. Considering that the externalization of financial toxicity involves the redistribution of the objective financial burden of cancer treatment, patient-level supportive care will need to be complemented by a long-term agenda aimed at mitigating the underlying causes of financial toxicity.
