From the Department of Plastic Surgery, Virginia Commonwealth University, Richmond, VA.
Division of Plastic Surgery, Baylor College of Medicine, Houston, TX.
Ann Plast Surg. 2024 Jan 1;92(1):34-40. doi: 10.1097/SAP.0000000000003720. Epub 2023 Oct 17.
Financial toxicity is a growing concern due to its considerable effects on medical adherence, quality of life, and mortality. The cost associated with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is substantial from diagnosis to treatment, including adjuvant therapy and surgery. This study aims to assess the prevalence of financial toxicity in BIA-ALCL patients.
We performed a cross-sectional, survey-based study on women with confirmed cases of BIA-ALCL from December 2019 to March 2023. The primary study outcomes were financial toxicity measured by Comprehensive Score for Financial Toxicity (COST) score and patient-reported financial burden measured by the responses to the Evaluation of the Financial Impact of BIA-ALCL survey. Lower COST scores signify higher financial toxicity. Responses were linked to patient data extracted from the medical records.
Thirty-two women treated for confirmed BIA-ALCL were included. Patients were all White and were diagnosed at a median age of 51 years (range, 41-65 years). The mean COST score was 27.9 ± 2.23. Lower COST scores were associated with receipt of radiotherapy ( P = 0.033), exceeding credit card limits ( P = 0.036), living paycheck to paycheck ( P = 0.00027), requiring financial support from friends and family ( P = 0.00044), and instability in household finances ( P = 0.034).
Financial toxicity is prevalent in BIA-ALCL patients and has a substantial impact on patient reported burden. Insurance denial is frequent for patients with a prior history of cosmetic augmentation. Risk assessments and cost discussions should occur throughout the care continuum to minimize financial burden.
由于其对医疗依从性、生活质量和死亡率的重大影响，经济毒性日益受到关注。从诊断到治疗，包括辅助治疗和手术，与乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）相关的成本是巨大的。本研究旨在评估 BIA-ALCL 患者的经济毒性的流行率。
我们对 2019 年 12 月至 2023 年 3 月期间确诊的 BIA-ALCL 女性进行了一项横断面、基于调查的研究。主要研究结果是通过综合经济毒性评分（COST）评分测量的经济毒性和通过 BIA-ALCL 评估财务影响调查的患者报告财务负担的测量。较低的 COST 评分表示更高的经济毒性。反应与从病历中提取的患者数据相关联。
32 名接受 BIA-ALCL 治疗的女性被纳入研究。患者均为白人，诊断中位年龄为 51 岁（范围为 41-65 岁）。平均 COST 评分为 27.9 ± 2.23。较低的 COST 评分与接受放疗（P=0.033）、超过信用卡额度（P=0.036）、靠工资生活（P=0.00027）、需要朋友和家人的经济支持（P=0.00044）以及家庭财务不稳定（P=0.034）有关。
经济毒性在 BIA-ALCL 患者中很普遍，并对患者报告的负担产生重大影响。对于有美容隆乳既往史的患者，保险拒绝很常见。应在整个护理过程中进行风险评估和成本讨论，以尽量减轻经济负担。
