Journal Article

Assessment of financial toxicity in patients with cancer in Slovenia

Zobec Logar, Helena Barbara, Ratoša, Ivica, Vöröš, Katja, Skubic, Marjeta, Bavdaž, Mojca, Došenović Bonča, Petra, Perhavec, Andraž, Redek, Tjaša

2025

Overview

Purpose The aim of this study was to assess the extent of financial toxicity in patients with cancer in Slovenia, measured as perceived financial strain and out-of-pocket expenditures. Methods The prospective, cross-sectional study was done at Institute of Oncology Ljubljana from June to October 2023. A newly created individual questionnaire was utilized to obtain data on financial toxicity. Patients completed the questionnaire either on paper or online, with or without the assistance of a researcher. The statistical analysis was based on descriptive and inferential statistics. Results A total of 901 surveys were disseminated, of which 659 were returned, corresponding to a response rate of 73%. Most patients had compulsory health insurance and were diagnosed in the public healthcare system. Following a cancer diagnosis, 178 (27%) patients reported a decline in financial satisfaction (subjective assessment), while 150 (22.7%) patients observed a change in their financial capability (objective assessment). Younger patients ( p  < 0.001), female patients ( p  < 0.004), patients with lower net household income ( p  < 0.001), and patients who were employed before the diagnosis ( p  < 0.001) were at a greater risk for financial toxicity. Patients with breast cancer and colorectal, endometrial, skin (including melanoma), esophageal, stomach, kidney, bladder cancers, and lymphoma had higher self-reported subjective and objective financial toxicity than patients with prostate, lung, and head and neck cancer. Conclusion This article represents the first comprehensive assessment of financial toxicity among patients with cancer in Slovenia, using perceived financial strain and out-of-pocket expenditures. Most patients reported no significant out-of-pocket costs for the treatment they received. About a quarter of patients with cancer experience financial difficulties.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adult / Age Factors / Aged / Bladder cancer / Breast cancer / Cancer / Cost of Illness / Cross-Sectional Studies / Economic stress / Esophageal cancer / Evaluation / Expenditures / Female / Financial Stress - economics / Financial Stress - epidemiology / Financing, Personal - statistics & numerical data / Head & neck cancer / Health care expenditures / Health care industry / Health Expenditures - statistics & numerical data / Health insurance / Health services / Humans / Insurance, Health - economics / Insurance, Health - statistics & numerical data / Low income groups / Lung cancer / Lymphoma / Male / Medical diagnosis / Medical treatment / Medicine / Medicine & Public Health / Middle Aged / Neoplasms - economics / Neoplasms - therapy / Nursing / Nursing Research / Oncology / Pain Medicine / Patients / Personal expenditure / Prospective Studies / Prostate / Prostate cancer / Quantitative analysis / Questionnaires / Rehabilitation Medicine / Satisfaction / Sex Factors / Skin cancer / Skin melanoma / Slovenia / Social health insurance / Statistical analysis / Statistical inference / Statistics / Stomach / Subjectivity / Surveys and Questionnaires / Toxicity / Young Adult