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FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ

Yıl 2021, Cilt: 24 Sayı: 3, 651 - 680, 29.09.2021

Öz

Kanser ile mücadele açısından son yıllarda yaşanan gelişmeler hastalar, aileleri ve tıp camiası için büyük umutlar ve heyecanlar yaratmaktadır. Ancak bu onkolojik yeniliklerin beraberinde getirdiği yüksek fiyat etiketi, tedavilerin hem bireysel hem de sağlık sistemi bazında karşılanabilirliği konusunda duyulan endişelerin giderek artmasına yol açmaktadır. Bu endişeler doğrultusunda üçüncü taraf ödeyiciler, kanser tedavisi maliyetlerinin önemli bir kısmını hastalara aktarma yoluna gitmektedir. Gerçekleşen bu maliyet paylaşımı kanser hastalarının daha fazla cepten harcama yapmasına ve finansal anlamda daha fazla sıkıntı yaşamasına neden olmaktadır. Kanser teşhisi ve tedavisinin hastalar üzerinde yarattığı bu ekonomik sıkıntı finansal toksisite olarak adlandırılmaktadır. Bu çalışmanın amacı; son zamanlarda büyük bir endişe konusu haline gelen ve kanserin yeni bir yan etkisi olarak kabul edilen finansal toksisite sorununu tüm yönleriyle ortaya koymaktır. Bu kapsamda; ilgili literatür taranarak sorunun kavramsal çerçevesi çizilmiş ve dünya genelinde farklı ülkelerden elde edilen araştırma sonuçları eşliğinde Türkiye de dahil olmak üzere çeşitli ülkelerde kanser hastalığı ile mücadele eden hastaların finansal toksisiteye maruziyeti, bu sorun ile ilişkili risk faktörleri ve bu sorunun hasta sonuçları üzerinde yarattığı etkiler kapsamlı olarak değerlendirilmiştir. Kanser tedavisinin finansal toksisitesi görece olarak yeni bir araştırma alanıdır. Sağlık sistemleri, geri ödeme modelleri ve tıbbi müdahaleler gelişmeye devam ettikçe, finansal toksisite kanser hastalarına ilişkin sonuçlar üzerinde önemli bir rol oynamaya devam edecektir. Bu nedenle bu konuda daha fazla çalışma yapılmasına ihtiyaç duyulmaktadır.

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FINANCIAL TOXICITY: A NEW SIDE EFFECT IN CANCER CARE

Yıl 2021, Cilt: 24 Sayı: 3, 651 - 680, 29.09.2021

Öz

Developments in the fight against cancer in recent years generate great hopes and excitement for patients, their families and the medical community. However, the high price tag brought about by these oncological innovations has led to an increasing concern about the affordability of treatments on both individual and health system levels. In line with these concerns, third-party payers prefer to shift a significant portion of cancer treatment costs to patients. This cost sharing results in considerable out-of-pocket expenses and financial hardship among patients with cancer. This economic hardship caused by cancer diagnosis and treatment on patients is called financial toxicity. The aim of this study is to reveal all aspects of the financial toxicity problem, which has become a major concern and is considered a new side effect of cancer recently. In this context, the conceptual framework of the problem has been generated by scanning relevant literature and exposure of patients struggling with cancer to financial toxicity in various countries, including Turkey, risk factors associated with this problem and effects’ of this problem on patient outcomes have been extensively evaluated. The financial toxicity of cancer treatment is a relatively new research area. As health systems, reimbursement models and medical interventions continue to evolve, financial toxicity will continue to play an important role in outcomes for cancer patients. Therefore, there is a need for more studies on this subject.

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  • Özmen, V. (2018). A patient advocacy group summit, cancer care in Turkey and the society of breast health. Eur J Breast Health, 14(1), 1-4.
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  • Pearce, A., Tomalin, B., Kaambwa, B., Horevoorts, N., Dujits, S., Mols, F., van de Poll-Franse, L., & Koczwara, B. (2019). Financial toxicity is more than costs of care: The relationship between employment and financial toxicity in long-term cancer survivors. Journal of Cancer Survivorship, 13(1), 10-20.
  • Perrone, F., Jommi, C., Di Maio, M., Gimigliano, A., Gridelli, C., Pignata, S., Ciardiello, F., Nuzzo, F., de Matteis, A., Del Mastro, L., Bryce, J., Daniele, G., Morabito, A., Piccirillo, M. C., Rocco, G., Guizzaro, L., & Gallo, C. (2016). The association of financial difficulties with clinical outcomes in cancer patients: Secondary analysis of 16 academic prospective clinical trials conducted in Italy. Annals of Oncology, 27(12), 2224-2229.
  • Philips, F., Kvale, E., Jones, B., Currin-Mcculloch, J., & Byelousova, A. (2019). The construct of financial toxicity and association with quality of life in poor populations (TH341A). Journal of Pain and Symptom Management, 57(2), 386.
  • Public Sector Consultants (2018). Financial navigation for people undergoing cancer treatment. Michigan Cancer Consortium. https://michigancancer.org adresinden 01.09.2020 tarihinde erişilmiştir.
  • Ramsey, S. D., Blough, D. K., Kirchhoff, A. C., Fedorenko, C. R., Snell, K. S., Kreizenbeck, K. L. Newcomb, P., Hollingworth, W, & Ovestreet, K. A. (2013). Washington cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis. Health Aff, 32(6), 1143-1152.
  • Ratain, M. J. (2009). Biomarkers and clinical care. Presented at the AAAS/FDLI Colloquium, Personalized Medicine in an Era of Health Care Reform, Washington, DC.
  • Ripamonti, C. I., Chiesi, F., Pede, P. D., Guglielmo, M., Toffolatti, L., Gangeri, L., & Allocca, E. (2020). The validation of the Italian version of the comprehensive score for financial toxicity (COST). Supportive Care in Cancer, 28(9), 4477-4485.
  • Rosenzweig, M., West, M., Matthews, J., Stokan, M., Kook, Y., Gallups, S., & Diergaarde, B. (2019). Financial toxicity among women with metastatic breast cancer. Oncology Nursing Forum, 46(1), 83-91.
  • Rotter, J., Spencer, J. C., 6 Wheeler, S. B. (2019). Financial toxicity in advanced and metastatic cancer: Overburdened and underprepared. J Oncol Pract, 15(4), e300-e307.
  • Sağlık Uygulama Tebliği (SUT). (2020). 16.06.2020 değişiklik tebliği işlenmiş güncel 2013 SUT. http://www.sgk.gov.tr adresinden 15.09.2020 tarihinde erişilmiştir.
  • SASAM Enstitüsü (2016). Sağlık sisteminin güçlendirilmesi (Odak grup görüşmeleri raporu). Ankara: Sağlık-Sen Yayınları-36.
  • Shankaran, V., & Ramsey, S. (2015). Addressing the financial burden of cancer treatment from copay to can’t pay. JAMA Oncology, 1(3), 273-274.
  • Sharp, L., & Timmons, A. (2010). The financial impact of a cancer diagnosis. National Cancer Registry/Irish Cancer Society.
  • Siminoff, L. A., & Ross, L. (2005). Access and equity to cancer care in the USA: A review and assessment. Postgrad Med, 81(961), 674-679.
  • Singleterry, J. (2017). The costs of cancer: Addressing patient costs. American Cancer Society Cancer Action Network.
  • Snyder, R. A., & Chang, G. J. (2019). Financial toxicity: A growing burden of cancer patients. Bulletin of the American College of Surgeons, 104(9), 38-43.
  • Sosyal Güvenlik Kurumu (SGK). (2012). Sosyal Güvenlik Kurumu aylık bülteni sigortalı istatistikleri, Ocak 2012. http://www.sgk.gov.tr/ adresinden 01.08.2020 tarihinde erişilmiştir.
  • Sosyal Güvenlik Kurumu (SGK) (2015). 01.12.2015 tarihli basın açıklaması: Kemoterapi ilaçları. T. C. Sosyal Güvenlik Kurumu Başkanlığı Basın ve Halkla İlişkiler Müşavirliği. 01.09.2020 tarihinde erişilmiştir.
  • Sosyal Güvenlik Kurumu (SGK). (2020). Sosyal Güvenlik Kurumu Aylık Bülteni Sigortalı İstatistikleri, Ocak 2020. http://www.sgk.gov.tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliğinde Değişiklik Yapılmasına Dair Tebliğ. (2018). Resmi Gazete, 30469, 5 Temmuz 2018.
  • Tatar, M., & Tatar, F. (2010). Colorectal cancer in Turkey: Current situation and challenges for the future. Eur J Health Econ, 10(Suppl 1), 99-105.
  • T.C. Aile, Çalışma ve Sosyal Hizmetler Bakanlığı (2021). SGK 2020 yılında ilaç için 48,6 milyar lira kaynak aktardı. https://www.ailevecalisma.gov.tr/ adresinden 01.03.2021 tarihinde erişilmiştir.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü (2018). 4 şubat dünya kanser günü. https://hsgm.saglik.gov.tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • The Action Study Group. (2015a). Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: Results from a longitudinal study in eight countries. BMC Medicine, 13:190. https://doi.org/10.1186/s12916-015-0433-1.
  • The Action Study Group. (2015b). Financial catastrophe, treatment discontinuation and death associated with surgically operable cancer in South-East Asia: Results from the ACTION study. Surgery, 157(6), 971-982.
  • Thom, B., & Benedict, C. (2019). The impact of financial toxicity on psychological well-being, coping self-efficacy, and cost-coping behaviors in young adults with cancer. Journal of Adolescent and Young Adult Oncology, 8(3), 236–242.
  • Ting, C. Y., Teh, G. C., Yu, K. L., Alias, H., Tan, H. M., & Wong, L. P. (2020). Financial toxicity and its associations with health-related quality of life among urologic cancer patients in an upper middle-income country. Supportive Care in Cancer Care 28(4), 1703-1715.
  • Tran, G., & Zafar, S. Y. (2018a). Financial toxicity and implications for cancer care in the era of molecular and immune therapies. Annals of Translational Medicine, 6(9):166. doi: 10.21037/atm.2018.03.28.
  • Tran, G., & Zafar, S. Y. (2018b). Price of cancer care and its tax on quality of life. Journal of Oncology Practice, 14(2), 69-71.
  • Tucker-Seeley, R. D., & Yabroff, K. R. (2016). Minimizing the “financial toxicity” associated with cancer care: Advancing the research agenda. J Natl Cancer Inst, 108(5), 1-3.
  • Türkiye İstatistik Kurumu (2013). Sağlık harcamaları istatistikleri 2009-2012. https://data.tuik.gov.tr/tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Türkiye İstatistik Kurumu (2014). Sağlık harcamaları istatistikleri 2013. https://data.tuik.gov.tr/tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Türkiye İstatistik Kurumu (2016). Sağlık harcamaları istatistikleri 2015. https://data.tuik.gov.tr/tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Türkiye İstatistik Kurumu (2018). Sağlık harcamaları istatistikleri 2017. https://data.tuik.gov.tr/tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Türkiye İstatistik Kurumu (2020). Sağlık harcamaları istatistikleri 2019. https://data.tuik.gov.tr/tr/ adresinden 01.09.2020 tarihinde erişilmiştir.
  • Uğurluoğlu, Ö., Ürek, D., & Bilgin Demir, İ. (2019). Evaluation of individuals’ satisfaction with health care services in Turkey. Health Policy and Technology, 8(1), 24-29.
  • Wan, N. C., Hairi, N. N. M., Jenn, N. C., & Kamarulzaman, A. (2014). Universal health coverage in Malaysia: Issues and challenges. http://familyrepository.lppkn.gov.my/399/4/Universal_health_ coverage_in_Malaysia_-_Full_Paper.pdf.
  • Williams, C. P., Pisu, M., Azuero, A., Kenzik, K. M., Nipp, R. D., Aswani, M. S., Mennemeyer, S. T., Pierce, J. Y., & Rocque, G. B. (2020). Health insurance literacy and financial hardship in women living with metastatic breast cancer. JCO Oncol Pract, 16(6), e529-e537.
  • Wright, J. D. (2019). Financial toxicity: A severe but underrecognized side effect for cancer patients. Gynecologic Oncology, 154(1), 1-2.
  • Yabroff, K. R., Lund, J., Kepka, D., & Mariotto, A. (2011). Economic burden of cancer in the United States: Estimates, projections, and future research. Cancer Epidemiol Biomarkers Prev, 20(10), 2006-2014.
  • Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, part II: How can we help with the burden of treatment-related costs?. Oncology, 27(4), 253-256.
  • Zafar, S. Y., Peppercorn, J. M., Schrag, D., Taylor, D. H., Goetzinger, A. M., Zhong, X., & Abernethy, A. P. (2013). The financial toxicity of cancer treatment: A pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. The Oncologist, 18(4), 381-390.
  • Zafar, S. Y., McNeil, R. B., Thomas, C. M., Lathan, C. S., Ayanian, J. Z., & Provenzale, D. (2015). Population-based assessment of cancer survivors’ financial burden and quality of life: A prospective cohort study. Journal of Oncology Practice, 11(2), 145-150.
  • Zafar, S. Y. (2016). Financial toxicity of cancer care: It’s time to intervene. J Natl Cancer Inst, 108(5): djv370. doi: 10.1093/jnci/djv370.
  • Zhu, Z., Xing, W., Lizarondo, L., Peng, J., Hu, Y., & So, W. K. (2020). Psychometric properties of self-reported financial toxicity measures in cancer survivors: A systematic review protocol using COSMIN Methodology. BMJ Open, 10:e036365. doi: 10.1136/bmjopen-2019-036365.
Toplam 126 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Duygu Ürek 0000-0001-6471-5601

Özgür Uğurluoğlu 0000-0002-9453-9925

Yayımlanma Tarihi 29 Eylül 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 24 Sayı: 3

Kaynak Göster

APA Ürek, D., & Uğurluoğlu, Ö. (2021). FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ. Hacettepe Sağlık İdaresi Dergisi, 24(3), 651-680.
AMA Ürek D, Uğurluoğlu Ö. FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ. HSİD. Eylül 2021;24(3):651-680.
Chicago Ürek, Duygu, ve Özgür Uğurluoğlu. “FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ”. Hacettepe Sağlık İdaresi Dergisi 24, sy. 3 (Eylül 2021): 651-80.
EndNote Ürek D, Uğurluoğlu Ö (01 Eylül 2021) FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ. Hacettepe Sağlık İdaresi Dergisi 24 3 651–680.
IEEE D. Ürek ve Ö. Uğurluoğlu, “FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ”, HSİD, c. 24, sy. 3, ss. 651–680, 2021.
ISNAD Ürek, Duygu - Uğurluoğlu, Özgür. “FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ”. Hacettepe Sağlık İdaresi Dergisi 24/3 (Eylül 2021), 651-680.
JAMA Ürek D, Uğurluoğlu Ö. FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ. HSİD. 2021;24:651–680.
MLA Ürek, Duygu ve Özgür Uğurluoğlu. “FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ”. Hacettepe Sağlık İdaresi Dergisi, c. 24, sy. 3, 2021, ss. 651-80.
Vancouver Ürek D, Uğurluoğlu Ö. FİNANSAL TOKSİSİTE: KANSER BAKIMINDA YENİ BİR YAN ETKİ. HSİD. 2021;24(3):651-80.