Financial toxicity is increasingly affecting patient quality of life and medication adherence in patients with cancer. Due to the use of novel therapies and the need for extended treatment duration, patients with multiple myeloma are more vulnerable to it.1

Patient-reported financial toxicity was common in an insured population with multiple myeloma, according to a study published online ahead of print in The Lancet Haematology.

Researchers performed a cross-sectional survey of 100 individuals receiving at least 3 months of ongoing treatment for multiple myeloma at a tertiary academic cancer center in the United States. It included the 11-item COST measure (financial toxicity score range 0 to 44).

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Eligible patients were given a paper survey to complete on arrival for routine follow-up visits, and were asked to finish it before or after the visit. Insurance and treatment data were gathered from the patients’ electronic health records.

Results showed that 59% of patients reported that treatment costs were higher than expected, 70% of patients had at least minor financial burden, 36% applied for financial assistance, and 21% of patients borrowed money to pay for medications. COST scores were correlated with patient-reported use of strategies to cope with myeloma treatment expenses.

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On multivariable analysis, younger age (correlation coefficient β: 0.36; 95% CI: 0.15 to 0.56; P=0.00092), non-married status (correlation coefficient β: 5.6; 95% CI: 1.5 to 9.6; P=0.0074), longer duration since diagnosis (correlation coefficient β: −4.8, 95% CI: −9·3 to −0·2; P=0.042), and lower household income ($40,000–79,999; correlation coefficient β: 7.8, 95% CI: 2.7 to 12.9; P=0.0031; ≥$80 000: correlation coefficient β: 11.8; 95% CI: 7.1 to 16·4; P<0.0001) were associated with higher financial burden as measured with the COST score.

Researchers concluded that additional attention should be paid to rising treatment costs and cost sharing is needed to address the increasing financial toxicity affecting patients with cancer.


  1. Huntington SF, Weiss B, Vogl DT, et al. Financial toxicity in insured patients with multiple myeloma: a cross-sectional pilot study. [published ahead of print September 17, 2015]. Lancet Haematol. doi: 10.1016/S2352-3026(15)00151-9.