Title
Atherosclerotic cardiovascular disease, cancer, and financial toxicity among adults in the United States
Document Type
Article
Department
Office of the Provost; Cardiology
Abstract
Background: Financial toxicity (FT) is a well-established side-effect of the high costs associated with cancer care. In recent years, studies have suggested that a significant proportion of those with atherosclerotic cardiovascular disease (ASCVD) experience FT and its consequences.
Objectives: This study aimed to compare FT for individuals with neither ASCVD nor cancer, ASCVD only, cancer only, and both ASCVD and cancer.
Methods: From the National Health Interview Survey, we identified adults with self-reported ASCVD and/or cancer between 2013 and 2018, stratifying results by nonelderly (age <65 years) and elderly (age ≥65 years). We defined FT if any of the following were present: any difficulty paying medical bills, high financial distress, cost-related medication nonadherence, food insecurity, and/or foregone/delayed care due to cost.
Results: The prevalence of FT was higher among those with ASCVD when compared with cancer (54% vs. 41%; p < 0.001). When studying the individual components of FT, in adjusted analyses, those with ASCVD had higher odds of any difficulty paying medical bills (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.09 to 1.36), inability to pay bills (OR: 1.25; 95% CI: 1.04 to 1.50), cost-related medication nonadherence (OR: 1.28; 95% CI: 1.08 to 1.51), food insecurity (OR: 1.39; 95% CI: 1.17 to 1.64), and foregone/delayed care due to cost (OR: 1.17; 95% CI: 1.01 to 1.36). The presence of ≥3 of these factors was significantly higher among those with ASCVD and those with both ASCVD and cancer when compared with those with cancer (23% vs. 30% vs. 13%, respectively; p < 0.001). These results remained similar in the elderly population.
Conclusions: Our study highlights that FT is greater among patients with ASCVD compared with those with cancer, with the highest burden among those with both conditions.
Publication ( Name of Journal)
JACC. CardioOncology
Recommended Citation
Valero-Elizondo, J.,
Chouairi, F.,
Khera, R.,
Grandhi, G. R.,
Saxena, A.,
Warraich, H. J.,
Virani, S. S.,
Desai, N. R.,
Sasangohar, F.,
Krumholz, H. M.
(2021). Atherosclerotic cardiovascular disease, cancer, and financial toxicity among adults in the United States. JACC. CardioOncology, 3(2), 236-246.
Available at:
https://ecommons.aku.edu/provost_office/413
Comments
This work was published before the author joined Aga Khan University.