Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis

Donkor, A; Atuwo-Ampoh, VD; Yakanu, F; Torgbenu, E; Ameyaw, EK; Kitson-Mills, D; Vanderpuye, V; Kyei, KA; Anim-Sampong, S; Khader, O; Khader, J

Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis

Atuwo-Ampoh, VD Yakanu, F Torgbenu, E Ameyaw, EK Kitson-Mills, D Vanderpuye, V Kyei, KA Anim-Sampong, S Khader, O Khader, J

Permalink

Publication Type:: Journal Article
Citation:: 2021
Issue Date:: 2021-02-05

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Submitted versionAdobe PDF (270.65 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Donkor, A https://orcid.org/0000-0002-6073-524X
dc.contributor.author	Atuwo-Ampoh, VD
dc.contributor.author	Yakanu, F
dc.contributor.author	Torgbenu, E
dc.contributor.author	Ameyaw, EK
dc.contributor.author	Kitson-Mills, D
dc.contributor.author	Vanderpuye, V
dc.contributor.author	Kyei, KA
dc.contributor.author	Anim-Sampong, S
dc.contributor.author	Khader, O
dc.contributor.author	Khader, J
dc.date.accessioned	2022-02-08T10:12:44Z
dc.date.available	2022-02-08T10:12:44Z
dc.date.issued	2021-02-05
dc.identifier.citation	2021
dc.identifier.uri	http://hdl.handle.net/10453/154307
dc.description.abstract	<h4>Introduction: </h4> The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low and middle-income countries (LMICs) is scarce. <h4>Aim: </h4> To identify the extent of cancer-related financial toxicity and how it has been measured in LMICs. <h4>Methods: </h4>: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to: costs; and determinants of financial toxicity. <h4>Results: </h4>: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of financial toxicity was 56.96% [95% CI, 30.51, 106.32]. In sub-group meta-analyses, the financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I 2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I 2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I 2 = 26%). Mean medical costs per cancer patients were $2,740.18 [95% CI, $1,953.62, $3,526.74]. The ratio of cost of care to gross domestic product (GDP) per capita varied considerably across the LMICs included in this review, which ranged from 0.06 in Vietnam to 327.65 in Ethiopia. <h4>Conclusions: </h4>: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.
dc.language	en
dc.relation.isbasedon	10.21203/rs.3.rs-161170/v1
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis
dc.type	Journal Article
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2022-02-08T10:12:43Z
pubs.publication-status	Published

Abstract:

Introduction:

The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low and middle-income countries (LMICs) is scarce.

Aim:

To identify the extent of cancer-related financial toxicity and how it has been measured in LMICs.

Methods:

: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to: costs; and determinants of financial toxicity.

Results:

: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of financial toxicity was 56.96% [95% CI, 30.51, 106.32]. In sub-group meta-analyses, the financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I 2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I 2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I 2 = 26%). Mean medical costs per cancer patients were $2,740.18 [95% CI, $1,953.62, $3,526.74]. The ratio of cost of care to gross domestic product (GDP) per capita varied considerably across the LMICs included in this review, which ranged from 0.06 in Vietnam to 327.65 in Ethiopia.

Conclusions:

: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/154307