Assistant Professor, Health Technology and Services Research, University of Twente, Enschede, The Netherlands.
Professor and Chairman, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
CA Cancer J Clin. 2018 Mar;68(2):153-165. doi: 10.3322/caac.21443. Epub 2018 Jan 16.
"Financial toxicity" has now become a familiar term used in the discussion of cancer drugs, and it is gaining traction in the literature given the high price of newer classes of therapies. However, as a phenomenon in the contemporary treatment and care of people with cancer, financial toxicity is not fully understood, with the discussion on mitigation mainly geared toward interventions at the health system level. Although important, health policy prescriptions take time before their intended results manifest, if they are implemented at all. They require corresponding strategies at the individual patient level. In this review, the authors discuss the nature of financial toxicity, defined as the objective financial burden and subjective financial distress of patients with cancer, as a result of treatments using innovative drugs and concomitant health services. They discuss coping with financial toxicity by patients and how maladaptive coping leads to poor health and nonhealth outcomes. They cover management strategies for oncologists, including having the difficult and urgent conversation about the cost and value of cancer treatment, availability of and access to resources, and assessment of financial toxicity as part of supportive care in the provision of comprehensive cancer care. CA Cancer J Clin 2018;68:153-165. © 2018 American Cancer Society.
“财务毒性”（Financial toxicity）如今已成为癌症药物讨论中一个耳熟能详的术语，鉴于新型疗法的高昂价格，该术语在文献中越来越受到关注。然而，作为当代癌症患者治疗和护理中的一种现象，财务毒性尚未被充分理解，对于其缓解措施的讨论主要侧重于医疗体系层面的干预。尽管这些措施很重要，但健康政策的实施需要时间才能显现出预期效果，如果能够实施的话。这些措施需要在个体患者层面制定相应的策略。在这篇综述中，作者讨论了财务毒性的本质，将其定义为癌症患者因使用创新药物和伴随的医疗服务而产生的客观财务负担和主观财务困境。他们讨论了患者应对财务毒性的方法，以及适应性不良的应对方式如何导致健康和非健康结果不佳。他们涵盖了肿瘤学家的管理策略，包括就癌症治疗的成本和价值、资源的可及性和可获得性进行艰难而紧迫的对话，以及将财务毒性评估作为提供全面癌症护理的支持性护理的一部分。CA Cancer J Clin 2018;68:153-165. © 2018 美国癌症协会。
