Financial burden in recipients of allogeneic hematopoietic cell transplantation

Nandita D Khera, Yu hui Chang, Shahrukh Hashmi, James L Slack, Timothy Beebe, Vivek Roy, Pierre Noel, Veena Fauble, Lisa Sproat, Jon C Tilburt, Jose F. Leis, Joseph R Mikhael

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Although allogeneic hematopoietic cell transplantation (HCT) is an expensive treatment for hematological disorders, little is known about the financial consequences for the patients who undergo this procedure. We analyzed factors associated with its financial burden and its impact on health behaviors of allogeneic HCT recipients. A questionnaire was retrospectively mailed to 482 patients who underwent allogeneic HCT from January 2006 to June 2012 at the Mayo Clinic, to collect information regarding current financial concerns, household income, employment, insurance, out-of-pocket expenses, and health and functional status. A multivariable logistic regression analysis identified factors associated with financial burden and treatment nonadherence. Of the 268 respondents (56% response rate), 73% reported that their sickness had hurt them financially. All patients for whom the insurance information was available (missing, n=13) were insured. Forty-seven percent of respondents experienced financial burden, such as household income decreased by >50%, selling/mortgaging home, or withdrawing money from retirement accounts. Three percent declared bankruptcy. Younger age and poor current mental and physical functioning increased the likelihood of financial burden. Thirty-five percent of patients reported deleterious health behaviors because of financial constraints. These patients were likely to be younger, have lower education, and with a longer time since HCT. Being employed decreased the likelihood of experiencing financial burden and treatment nonadherence due to concern about costs. A significant proportion of allogeneic HCT survivors experience financial hardship despite insurance coverage. Future research should investigate potential interventions to help at-risk patients and prevent adverse financial outcomes after this life-saving procedure.

Original languageEnglish (US)
Pages (from-to)1375-1381
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number9
DOIs
StatePublished - 2014

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Cell Transplantation
Health Behavior
Insurance
Bankruptcy
Insurance Coverage
Retirement
Health Expenditures
Health Status
Survivors
Therapeutics
Logistic Models
Regression Analysis
Education
Costs and Cost Analysis
Surveys and Questionnaires

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Economics
  • Financial burden
  • Quality of life

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Financial burden in recipients of allogeneic hematopoietic cell transplantation. / Khera, Nandita D; Chang, Yu hui; Hashmi, Shahrukh; Slack, James L; Beebe, Timothy; Roy, Vivek; Noel, Pierre; Fauble, Veena; Sproat, Lisa; Tilburt, Jon C; Leis, Jose F.; Mikhael, Joseph R.

In: Biology of Blood and Marrow Transplantation, Vol. 20, No. 9, 2014, p. 1375-1381.

Research output: Contribution to journalArticle

Khera, Nandita D ; Chang, Yu hui ; Hashmi, Shahrukh ; Slack, James L ; Beebe, Timothy ; Roy, Vivek ; Noel, Pierre ; Fauble, Veena ; Sproat, Lisa ; Tilburt, Jon C ; Leis, Jose F. ; Mikhael, Joseph R. / Financial burden in recipients of allogeneic hematopoietic cell transplantation. In: Biology of Blood and Marrow Transplantation. 2014 ; Vol. 20, No. 9. pp. 1375-1381.
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