The socio-economic consequences of cancer - an underestimated problem
Many cancer patients suffer not only from health problems, but experience loss of income and out-of-pocket expenditures for medical services. This is true even in European countries with high incomes and comprehensive health insurance systems. This problem has been largely underestimated in the past and little systematic research has been carried out. The Organization of European Cancer Institutes (OECI) is now presenting consensus recommendations to guide future research into the socio-economic consequences of cancer.
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So far, the problem has been researched mainly in the US, focusing on so-called "financial toxicity" as a result of expensive treatment and often limited insurance coverage. This overlooks the fact that financial burdens often have socio-economic consequences for cancer patients and their families.
European research to date is limited and hampered by heterogeneous methods and a lack of standardized terminology. To address this shortcoming and guide research and policy on these issues, a task force initiated by the OECI has now presented 25 recommendations that provide a comprehensive definition of "socioeconomic impact" from the perspective of patients and their families and propose a standardized taxonomy. The OECI Task Force's consensus statement also identifies directions for future research that may also inform policy decisions to alleviate the socioeconomic burden of cancer patients.
The OECI Task Force was led by Michael Schlander, German Cancer Research Center (DKFZ) and Institute for Innovation & Valuation in Health Care (InnoVal-HC,) and Wim van Harten from the Netherlands Cancer Institute. In a two-year process, the researchers developed 25 consensus recommendations. The consensus was endorsed by 25 co-authors representing the leading cancer research centers across Europe. It proposes a neutral scientific definition of socioeconomic impact, a comprehensive framework that defines the different dimensions and a broader scope, and recommends directions and standards for future studies.
The consensus of the OECI Task Force fills an important gap, as the financial burden of many cancer patients leads to psychological problems and reduced quality of life. Even the success of treatment can be impaired, which can be associated with a higher mortality rate. The problem affects patients at all stages of the disease, from diagnosis through treatment to long-term survival, and extends to partners and family members.
However, the factors that predict the vulnerability of certain patient groups to financial stress and burden are only partially understood, and there is a lack of robust data on the extent of the problem and knowledge of effective interventions.
Claudio Lombardo, Director General of the OECI, emphasizes the importance of these consensus recommendations: "The work can contribute to a better understanding of the problems faced by patients. It provides guidance for improvements and policy measures to reduce the socio-economic burdens that patients face."
In follow-up projects, the researchers plan to structure further research, develop and validate measurement tools and also develop tools to help oncologists better support patients in this area.
The Organization of European Cancer Institutes (OECI) was founded in 1979 and currently has 141 member organizations from Europe and increasingly from other continents. The Task Force on the Socio-Economic Impact of Cancer was set up by Michael Schlander as part of the OECI Working Group on Health Economics. The members of the Task Force represent health economists from cancer centers in 25 EU countries, Chile and Palestine.
Publication:
Michael Schlander et al.: The socioeconomic impact of cancer on patients and their relatives: Organisation of European Cancer Institutes task force consensus recommandations on conceptual framework, taxonomy, and research directions.
The Lancet Oncology 2024, DOI: https://doi.org/10.1016/S1470-2045(23)00636-8
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