Abstract
Purpose
To illustrate the out-of-pocket (OOP) costs incurred by a population-based group of patients from 5 to 10 years since their cancer diagnosis in a country with a nationwide public health system.
Methods
Interviews on OOP costs to a sample of 5–10 year prevalent cases randomly extracted from four population-based cancer registries (CRs), two in the north and two in the south of Italy. The patients’ general practitioners (GPs) gave assurance about the patient’s physical and psychological condition for the interview. A zero-inflated negative binomial model was used to analyze OOP cost determinants.
Results
Two hundred six cancer patients were interviewed (48 % of the original sample). On average, a patient in the north spent €69 monthly, against €244 in the south. The main differences are for transport, room, and board (TRB) to reach the hospital and/or the cancer specialist (north €0; south €119). Everywhere, OOP costs without TRB costs were higher for patients with a low quality of life.
Conclusions
Despite the limited participation, our study sample’s characteristics are similar to those of the Italian cancer prevalence population, allowing us to generalize the results. The higher OOP costs in the south may be due to the scarcity of oncologic structures, obliging patients to seek assistance far from their residence.
Implications for cancer survivors
Cancer survivors need descriptive studies to show realistic data about their status. Future Italian and European descriptive studies on cancer survivorship should be based on population CRs and involve GPs in order to approach the patient at best.
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Acknowledgments
The study was subsidized by Italian Association of Medical Oncologists (AIOM) and Regione Lombardia through the ROL network. We thank Jessica Rossi for the interviews; Francesca Ferrari, Maria Rosa Ruzza, and Anna Maghini for data collection; and the Associazione Senza Limiti voluntary association, AIRE ONLUS Ragusa, and General Practitioners Ragusa for the support in the study organization.
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The study was approved by the Independent Ethics Committee of the Fondazione IRCCS “Istituto Nazionale dei Tumori” and by the institutional review boards linked with CRs.
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The authors declare that they have no competing interests.
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Baili, P., Di Salvo, F., de Lorenzo, F. et al. Out-of-pocket costs for cancer survivors between 5 and 10 years from diagnosis: an Italian population-based study. Support Care Cancer 24, 2225–2233 (2016). https://doi.org/10.1007/s00520-015-3019-8
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DOI: https://doi.org/10.1007/s00520-015-3019-8