A Costly Cure: Understanding and Addressing Financial Toxicity in Cardiovascular Disease Health Care Within the Domain of Social Determinants of Health
References
- Heart [Internet]. Washington, DC: American Heart Association Office of Federal Advocacy; c2024.
Cardiovascular Disease: A Costly Burden for America: Projections Through 2035 ; 2017 [cited 2024 Oct 6]. Available from:https://www.heart.org/-/media/Files/About-Us/Policy-Research/Fact-Sheets/Public-Health-Advocacy-and-Research/CVD-A-Costly-Burden-for-America-Projections-Through-2035.pdf - Abdus S, Keenan PS. Financial Burden of Employer-Sponsored High-Deductible Health Plans for Low-Income Adults With Chronic Health Conditions. JAMA Intern Med. 2018 Dec 1;178(12):1706-1708. doi: 10.1001/jamainternmed.2018.4706
- Smith GL, Lopez-Olivo MA, Advani PG, et al. Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes. J Natl Compr Canc Netw. 2019 Oct 1;17(10):1184-1192. doi: 10.6004/jnccn.2019.7305
- Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. J Am Heart Assoc. 2020 Oct 20;9(19):
e017793 . doi: 10.1161/JAHA.120.017793 - Warraich HJ, Ali HJR, Nasir K. Financial Toxicity With Cardiovascular Disease Management: A Balancing Act for Patients. Circ Cardiovasc Qual Outcomes. 2020 Dec;13(12):
e007449 . doi: 10.1161/CIRCOUTCOMES.120.007449 - Luo F, Chapel G, Ye Z, Jackson SL, Roy K. Labor Income Losses Associated With Heart Disease and Stroke From the 2019 Panel Study of Income Dynamics. JAMA Netw Open. 2023 Mar 1;6(3):
e232658 . doi: 10.1001/jamanetworkopen.2023.2658 - Thomas A, Valero-Elizondo J, Khera R, et al. Forgone Medical Care Associated With Increased Health Care Costs Among the U.S. Heart Failure Population. JACC Heart Fail. 2021 Oct;9(10):710-719. doi: 10.1016/j.jchf.2021.05.010
- Perrone F, Jommi C, Di Maio M, et al. The association of financial difficulties with clinical outcomes in cancer patients: secondary analysis of 16 academic prospective clinical trials conducted in Italy. Ann Oncol. 2016 Dec;27(12):2224-2229. doi: 10.1093/annonc/mdw433
- Ramsey SD, Bansal A, Fedorenko CR, et al. Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer. J Clin Oncol. 2016 Mar 20;34(9):980-6. doi: 10.1200/JCO.2015.64.6620
- Ma SJ, Iovoli AJ, Attwood K, et al. Association of significant financial burden with survival for head and neck cancer patients treated with radiation therapy. Oral Oncol. 2021 Apr:115:
105196 . doi: 10.1016/j.oraloncology.2021.105196 - Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist. 2013;18(4):381-90. doi: 10.1634/theoncologist.2012-0279
- Meropol NJ, Schrag D, Smith TJ, et al. American Society of Clinical Oncology guidance statement: the cost of cancer care. J Clin Oncol. 2009 Aug 10;27(23):3868-74. doi: 10.1200/JCO.2009.23.1183
- Obama B. United States Health Care Reform: Progress to Date and Next Steps. JAMA. 2016 Aug 2;316(5):525-32. doi: 10.1001/jama.2016.9797
- Wang SY, Valero-Elizondo J, Cainzos-Achirica M, Desai NR, Nasir K, Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US. JAMA Health Forum. 2022 Jul 22;3(7):
e221962 . doi: 10.1001/jamahealthforum.2022.1962 - Khera R, Valero-Elizondo Javier, Okunrintemi V, et al. Association of Out-of-Pocket Annual Health Expenditures With Financial Hardship in Low-Income Adults With Atherosclerotic Cardiovascular Disease in the United States. JAMA Cardiol. 2018 Aug 1;3(8):729-738. doi: 10.1001/jamacardio.2018.1813
- Wang SY, Valero-Elizondo J, Ali HJ, et al. Out-of-Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States. J Am Heart Assoc. 2021 Jul 20;10(14):
e022164 . doi: 10.1161/JAHA.121.022164 - GoodRx [Internet]. Santa Monica, CA: GoodRx; c2024.
Entresto fact sheet ; 2023 Jun [cited 2024 Oct 6]. Available from:https://www.goodrx.com/entresto/what-is?label_override=undefined - GoodRx [Internet]. Santa Monica, CA: GoodRx; c2024.
Jardiance fact sheet ; 2023 [cited 2024 Oct 6]. Available from:https://www.goodrx.com/jardiance?utm_campaign=16074693778&utm_content=132584585973&utm_source=google&utm_medium=cpc&utm_term=kwd-819146029810&gclid=CjwKCAjw4_K0BhBsEiwAfVVZ_5E7Cjwb9X8UgxsGVPDsnXGfpMpz72zYIaRN0lNYIcUd17tAyUCA5xoCqsUQAvD_BwE&gclsrc=aw.ds&dosage=10mg&form=tablet&quantity=30&label_override=jardiance - US Census [Internet]. Washington, DC: US Census Bureau; c2024. Guzman G, Kollar M.
Income in the United States: 2022 ; 2023 Sept [cited 2024 Aug 12]. Available from:https://www.census.gov/content/dam/Census/library/publications/2023/demo/p60-279.pdf - Faridi KF, Dayoub EJ, Ross JS, Dhruva SS, Ahmad T, Desai NR. Medicare Coverage and Out-of-Pocket Costs of Quadruple Drug Therapy for Heart Failure. J Am Coll Cardiol. 2022 Jun 28;79(25):2516-2525. doi: 10.1016/j.jacc.2022.04.031
- Shore S, Basu T, Kamdar N, et al. Use and Out-of-Pocket Cost of Sacubitril-Valsartan in Patients With Heart Failure. J Am Heart Assoc. 2022 Sep 6;11(17):
e023950 . doi: 10.1161/JAHA.121.023950 - Aggarwal R, Vaduganathan M, Chiu N, Bhatt DL. Out-of-Pocket Costs for SGLT-2 (Sodium-Glucose Transport Protein-2) Inhibitors in the United States. Circ Heart Fail. 2022 Mar;15(3):
e009099 . doi: 10.1161/CIRCHEARTFAILURE.121.009099 - Valero-Elizondo J, Khera R, Saxena A, et al. Financial Hardship From Medical Bills Among Nonelderly U.S. Adults With Atherosclerotic Cardiovascular Disease. J Am Coll Cardiol. 2019 Feb 19;73(6):727-732. doi: 10.1016/j.jacc.2018.12.004
- Ali HJR, Valero-Elizondo J, Wang SY, et al. Subjective Financial Hardship due to Medical Bills Among Patients With Heart Failure in the United States: The 2014-2018 Medical Expenditure Panel Survey. J Card Fail. 2022 Sep;28(9):1424-1433. doi: 10.1016/j.cardfail.2022.06.009
- Bernard D, Fang Z. Financial Burdens and Barriers to Care Among Nonelderly Adults With Heart Disease: 2010-2015. J Am Heart Assoc. 2019 Dec 17;8(24):
e008831 . doi: 10.1161/JAHA.118.008831 - Kaneko H, Itoh H, Yotsumoto H, et al. Association between the number of hospital admissions and in-hospital outcomes in patients with heart failure. Hypertens Res. 2020 Dec;43(12):1385-1391. doi: 10.1038/s41440-020-0505-2
- de Souza JA, Yap BJ, Wroblewski K, et al. Measuring financial toxicity as a clinically relevant patient-reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST). Cancer. 2017 Feb 1;123(3):476-484. doi: 10.1002/cncr.30369
- Patel MR, Zhang G, Heisler M, et al. Measurement and Validation of the Comprehensive Score for Financial Toxicity (COST) in a Population With Diabetes. Diabetes Care. 2022 Nov 1;45(11):2535-2543. doi: 10.2337/dc22-0494
- Pavela G, Fifolt M, Tison SE, Allison M, Burton BS, Ford EW. Re-Validation of the COmprehensive Score for Financial Toxicity (COST): Assessing the Scale’s Utility in Chronic Disease Populations. Health Serv Insights. 2021 Dec 10:14:11786329211057352. doi: 10.1177/11786329211057352
- Xu C, Smith GL, Chen YS, et al. Short-form adaptive measure of financial toxicity from the Economic Strain and Resilience in Cancer (ENRICh) study: Derivation using modern psychometric techniques. PLoS One. 2022 Aug 25;17(8):
e0272804 . doi: 10.1371/journal.pone.0272804 - Foote JHA, Kazi DS. The March Toward Improved Heart Failure Outcomes Requires an Emphasis on Affordability. JACC Heart Fail. 2024 Jul;12(7):1238-1241. doi: 10.1016/j.jchf.2024.04.019
- Narasimmaraj PR, Oseran A, Tale A, et al. Out-of-Pocket Drug Costs for Medicare Beneficiaries With Cardiovascular Risk Factors Under the Inflation Reduction Act. J Am Coll Cardiol. 2023 Apr 18;81(15):1491-1501. doi: 10.1016/j.jacc.2023.02.002
- Kazi DS, DeJong C, Chen R, Wadhera RK, Tseng CW. The Inflation Reduction Act and Out-of-Pocket Drug Costs for Medicare Beneficiaries With Cardiovascular Disease. J Am Coll Cardiol. 2023 May 30;81(21):2103-2111. doi: 10.1016/j.jacc.2023.03.414
- Mszar R, Grandhi GR, Valero-Elizondo J, et al. Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non-Elderly Adults in the United States. J Am Heart Assoc. 2020 May 18;9(10):
e015523 . doi: 10.1161/JAHA.119.015523 - Valero-Elizondo J, Javed Z, Khera R, et al. Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey. Arch Public Health. 2022 Dec 6;80(1):248. doi: 10.1186/s13690-022-00987-z
- Jewett PI, Purani H, Vogel RI, Parsons HM, Borrero M, Blaes A. Comparisons of financial hardship in cancer care by family structure and among those with and without minor children using nationally representative data. Cancer Med. 2024 Mar;13(6):
e7088 . doi: 10.1002/cam4.7088 - Dunbar SB, Khavjou OA, Bakas T, et al. Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association. Circulation. 2018 May 8;137(19):e558-e577. doi: 10.1161/CIR.0000000000000570
- Ghazal LV, Abrahamse P, Ward KC, Morris AM, Hawley ST, Veenstra CM. Financial Toxicity and Its Association With Health-Related Quality of Life Among Partners of Colorectal Cancer Survivors. JAMA Netw Open. 2023 Apr 3;6(4):
e235897 . doi: 10.1001/jamanetworkopen.2023.5897 - Becker NV, Scott JW, Moniz MH, Carlton EF, Ayanian JZ. Association of Chronic Disease With Patient Financial Outcomes Among Commercially Insured Adults. JAMA Intern Med. 2022 Oct 1;182(10):1044-1051. doi: 10.1001/jamainternmed.2022.3687
- Taha MB, Valero-Elizondo J, Yahya T, et al. Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018. Diabetes Care. 2022 Mar 1;45(3):594-603. doi: 10.2337/dc21-1757
- Khera R, Valero-Elizondo J, Das SR, et al. Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017. Circulation. 2019 Dec 17;140(25):2067-2075. doi: 10.1161/CIRCULATIONAHA.119.041974
- Valero-Elizondo J, Chouairi F, Khera R, et al. Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States. JACC CardioOncol. 2021 Jun 15;3(2):236-246. doi: 10.1016/j.jaccao.2021.02.006
- Agarwal A, Livingstone A, Karikios DJ, Stockler MR, Beale PJ, Morton RL. Physician-patient communication of costs and financial burden of cancer and its treatment: a systematic review of clinical guidelines. BMC Cancer. 2021 Sep 16;21(1):
1036 . doi: 10.1186/s12885-021-08697-5 - Ehsan AN, Wu CA, Minasian A, et al. Financial Toxicity Among Patients With Breast Cancer Worldwide: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023 Feb 1;6(2):
e2255388 . doi: 10.1001/jamanetworkopen.2022.55388 - Uppal N, Cunningham Nee Lubitz C, James B. The Cost and Financial Burden of Thyroid Cancer on Patients in the US: A Review and Directions for Future Research. JAMA Otolaryngol Head Neck Surg. 2022 Jun 1;148(6):568-575. doi: 10.1001/jamaoto.2022.0660
- Azzani M, Atroosh WM, Anbazhagan D, Kumarasamy V, Abdalla MMI. Describing financial toxicity among cancer patients in different income countries: a systematic review and meta-analysis. Front Public Health. 2024 Jan 2:11:
1266533 . doi: 10.3389/fpubh.2023.1266533 - KFF [Internet]. San Francisco, CA: Kaiser Family Foundation; c2024. Artiga S, Hinton E.
Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity ; 2018 May [cited 2024 July 24]. Available from:https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/ - Dickert NW, Mitchell AR, Venechuk GE, et al. Show Me the Money: Patients’ Perspectives on a Decision Aid for Sacubitril/Valsartan Addressing Out-of-Pocket Cost. Circ Cardiovasc Qual Outcomes. 2020 Dec;13(12):
e007070 . doi: 10.1161/CIRCOUTCOMES.120.007070 - Rao BR, Akrobetu DJ, Dickert NW, et al. Deciding Whether to Take Sacubitril/Valsartan: How Cardiologists and Patients Discuss Out-of-Pocket Costs. J Am Heart Assoc. 2023 Apr 4;12(7):
e028278 . doi: 10.1161/JAHA.122.028278 - Montembeau SC, Rao BR, Mitchell AR, et al. Integrating Cost into Shared Decision-Making for Heart Failure with Reduced Ejection Fraction (POCKET-COST-HF): A Trial Providing Out-of-Pocket Costs for Heart Failure Medications during Clinical Encounters. Am Heart J. 2024. doi: 10.1016/j.ahj.2023.11.013
- Kircher SM, Yarber J, Rutsohn J, et al. Piloting a Financial Counseling Intervention for Patients With Cancer Receiving Chemotherapy. J Oncol Pract. 2019 Mar;15(3):e202-e210. doi: 10.1200/JOP.18.00270
- Sadigh G, Coleman D, Switchenko JM, Hopkins JO, Carlos RC. Treatment out-of-pocket cost communication and remote financial navigation in patients with cancer: a feasibility study. Support Care Cancer. 2022 Oct;30(10):8173-8182. doi: 10.1007/s00520-022-07270-5
- Tarnasky AM, Tran GN, Nicolla J, et al. Mobile Application to Identify Cancer Treatment-Related Financial Assistance: Results of a Randomized Controlled Trial. JCO Oncol Pract. 2021 Oct;17(10):e1440-e1449. doi: 10.1200/OP.20.00757
- Hamel LM, Dougherty DW, Hastert TA, et al. The DISCO App: A pilot test of a multi-level intervention to reduce the financial burden of cancer through improved cost communication. PEC Innov. 2021 Oct 30:1:
100002 . doi: 10.1016/j.pecinn.2021.100002 - Raghavan D, Keith NA, Warden HR, et al. Levine Cancer Institute Financial Toxicity Tumor Board: A Potential Solution to an Emerging Problem. JCO Oncol Pract. 2021 Oct;17(10):e1433-e1439. doi: 10.1200/OP.21.00124
- Ning MS, Palmer MB, Shah AK, et al. Three-Year Results of a Prospective Statewide Insurance Coverage Pilot for Proton Therapy: Stakeholder Collaboration Improves Patient Access to Care. JCO Oncol Pract. 2020 Sep;16(9):e966-e976. doi: 10.1200/JOP.19.00437
- Politi MC, Grant RL, George NP, et al. Improving Cancer Patients’ Insurance Choices (I Can PIC): A Randomized Trial of a Personalized Health Insurance Decision Aid. Oncologist. 2020 Jul;25(7):609-619. doi: 10.1634/theoncologist.2019-0703
- Knight TG, Aguiar M, Robinson M, et al. Financial Toxicity Intervention Improves Outcomes in Patients With Hematologic Malignancy. JCO Oncol Pract. 2022 Sep;18(9):e1494-e1504. doi: 10.1200/OP.22.00056
DOI: https://doi.org/10.14797/mdcvj.1466 | Journal eISSN: 1947-6108
Language: English
Page range: 15 - 26
Submitted on: Aug 20, 2024
Accepted on: Aug 30, 2024
Published on: Nov 5, 2024
Published by: Houston Methodist DeBakey Heart & Vascular Center
In partnership with: Paradigm Publishing Services
© 2024 Vijay Aaroha Kandula, Grace Li Smith, Ravi Rajaram, Nicolas L. Palaskas, Anita Deswal, Khurram Nasir, Hyeon-Ju Ryoo Ali, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.