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Published on: October 27, 2014
Financial toxicity in patients with glioblastoma
Danielle Terrell1, Joseph Camarano1, Stephen Whipple1
1Department of Neurosurgery, Louisiana State University Health Sciences Center- Shreveport, Shreveport, LA, USA.
Purpose:
There has been mounting interest in understanding the impact of financial toxicity (FT) in various cancer types; however, it remains poorly understood and understudied within neuro-oncology-especially as it relates to neurosurgical components of patient care.
Methods:
Retrospective, single-center study of patients who underwent craniotomy for resection of glioblastoma from 2020 to 2022. OIBEE™ (Austin, Texas) software was queried to identify the subset of these patients who had a bad debt charged to their account. These patients were deemed to qualify as experiencing FT. Chi Square analysis was conducted between FT and non-FT patient groups. Additionally, survival analyses were performed to determine predictors of progression free and overall survival.
Results:
74 patients were included in this sample. 33/74 (44%) met criteria for FT. The average bad debt amount was $7,476.76 and the median debt amount was $2,015.96, with the average time to financial toxicity after surgery being approximately 127 days. FT patients were significantly younger at diagnosis than those who were not FT (64.6 years- non-FT vs. 59.0 years- FT, p = 0.0344). FT patients were more likely to have undergone subtotal resections rather than a gross total resection compared to non-FT patients (FT GTR 27.3%, non-FT GTR 52.4%, p = 0.028). Hospital length of stay was significantly longer for FT patients compared to non-FT patients (LOS FT 9.5 days, non-FT 6.5 days, p = 0.0312).
Conclusion:
Glioblastoma patients are at high risk of experiencing FT with our series showing no significant impact on overall survival. Larger studies are needed to understand the impact of FT on patient outcomes.
Insights
Glioblastoma patients undergoing surgery face significant financial toxicity (FT), with 44% experiencing bad debt. This financial burden impacts younger patients and is linked to longer hospital stays but not overall survival.
Area of Science:
- Neurosurgery
- Oncology
- Health Economics
Background:
- Financial toxicity (FT) is a growing concern in cancer care.
- Its impact within neuro-oncology, particularly after neurosurgery for brain tumors, is understudied.
Purpose of the Study:
- To investigate the prevalence and characteristics of financial toxicity in glioblastoma patients undergoing craniotomy.
- To explore the association between FT and patient demographics, surgical outcomes, and survival.
Main Methods:
- Retrospective analysis of 74 glioblastoma patients who had craniotomy between 2020-2022.
- FT was defined by the presence of bad debt on patient accounts.
- Chi-square and survival analyses were used to compare FT and non-FT groups.
Main Results:
- 44% of patients experienced FT, with an average bad debt of $7,476.76.
- FT patients were younger (59.0 vs 64.6 years) and more likely to have subtotal resections.
- FT was associated with a longer hospital length of stay (9.5 vs 6.5 days).
Conclusions:
- Glioblastoma patients are at high risk for financial toxicity post-neurosurgery.
- While FT impacts certain patient characteristics and hospital stay, it did not significantly affect overall survival in this cohort.
- Further research with larger cohorts is necessary to fully elucidate the impact of FT on patient outcomes.
