Quantifying financial toxicity in oncology: A comprehensive analysis of prescription cost disparities using public data from 2022.

Abstract

1612 Background: Financial toxicity in cancer care poses a significant burden for patients and healthcare systems. This study analyzed public data to evaluate the financial impact of oncology treatments, focusing on factors such as demographics, insurance type, gender disparities, or geographics. Methods: The 2022 Medical Expenditure Panel Survey (MEPS) data was analyzed, focusing on antineoplastic and immunologic agents. Cost distributions, payment sources, and financial burden—defined as prescription costs exceeding 20% of annual household income—were assessed across various insurances and demographic groups (age, gender, race, income, and education). Geographic analyses utilized Federal Information Processing Standard (FIPS) state codes. Results: The study included 1,379 oncology prescriptions. Prescription costs averaged 1,569 per prescription (median 388), ranging from 19 to 7,208. Annual costs spanned 2,507 (25th percentile) to 26,857 (75th percentile), with a median of 3,561 and a mean of 14,138. Non-prescription medical costs, such as procedures and hospitalizations, had a median of 45,475 and a mean of 47,509, with some exceeding 132,396 annually. Uninsured patients faced the highest average costs (78,439 annually), followed by Medicare patients (67,979). Medicaid patients had the lowest total costs (53,469). VA/TRICARE patients showed moderate costs (56,619) but higher prescription expenses (16,758). Low-income patients faced the greatest financial burden, spending 11.71% of their income on prescriptions, compared to 5.89% for middle-income and 2.66% for high-income patients. Private insurance beneficiaries faced the highest costs (5,500-6,000), particularly among Black and White patients, followed by Medicare (4,500-5,000). Medicaid beneficiaries incurred lower costs (3,500-4,000), while uninsured patients had the lowest mean costs (2,500-3,000), reflecting limited access to comprehensive treatments. Female patients had higher costs for breast and lung cancer treatments. Black and Hispanic patients relied more on Medicaid. Patients with graduate degrees had higher average costs (4,226) than those with a high school education or less (3,707). Geographically, financial burden was highest in the Midwest, moderate in the Northeast, and mixed in coastal and Southern states. Conclusions: Significant disparities in financial toxicity exist across demographics, insurance types, and regions. The gap between mean and median costs underscores the disproportionate financial strain faced by some patients. Policy interventions, including expanded insurance coverage, capped out-of-pocket costs, and targeted subsidies, are needed to improve equity and affordability in cancer care.