ArticleBMC cancer2020
The patient-level effect of the cost of Cancer care - financial burden in German Cancer patients.
Article in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and determinants of financial toxicity in patients with colorectal cancer: a systematic review and meta-analysis.International journal for equity in health · 2026Pooled it
- Towards the assessment of financial distress among cancer patients: a conceptual model of the financial effects of a tumour disease.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Empathy, access, and delays: determinants of oncology care satisfaction in Polish academic and nonacademic hospitals.The oncologist · 2026Article
- The influence of urban versus rural residence and travel distance on net income, out-of-pocket payments and quality of life in German head and neck cancer survivors.Journal of cancer research and clinical oncology · 2026Article
- The financial burden resulting from complementary and alternative medicine in oncology care.BMC complementary medicine and therapies · 2026Article
- The role of financial distress as a patient-relevant endpoint in early benefit assessments for oncology drugs: a mixed-methods document analysis.International journal of technology assessment in health care · 2026Article
- Complementary and Alternative Medicine in Oncology: A Concise Review of Utilization, Evidence, and Integration Challenges.Cancer reports (Hoboken, N.J.) · 2026Review
- Longitudinal development and clinical predictors of financial toxicity among radiation oncology patients: final results of the SOCOFIN study.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Article
- Socioeconomic differences in return to work after oncological rehabilitation: An analysis using data from German Pension Insurance.Journal of health monitoring · 2026Article
- The relationship between resilience, financial toxicity, and quality of life in patients with primary liver cancer: a cross-sectional study.BMC gastroenterology · 2025Article
- The multifaceted impact of circadian disruption on cancer risk: a systematic review of insights and economic implications.Journal of the National Cancer Center · 2025Review
- Socioeconomic impact among and socioeconomic support services for adolescents and young adults with cancer: A European perspective.International journal of cancer · 2025Article
- Article
- Assessment of financial toxicity in patients with cancer in Slovenia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Self-reported financial difficulties of colorectal cancer patients 1 year after start of treatment.ESMO open · 2025Article
- Prevalence and impact of financial toxicity in older patients with cancer: a prospective observational study in India.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Financial Toxicity Among Cancer Patients in Slovenia.Cancer medicine · 2025Article
- Article
- Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients.BMJ open · 2025Observational
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundFinancial toxicity of cancer has so far been discussed primarily in the US health care system and is associated with higher morbidity and mortality. In European health care systems, the socio-economic impact of cancer is poorly understood. This study investigates the financial burden and patient-reported outcomes of neuroendocrine (NET) or colorectal (CRC) cancer patients at a German Comprehensive Cancer Center.
methodsThis prospective cross-sectional study surveyed 247 advanced stage patients (n = 122 NET/n = 125 CRC) at the National Center for Tumor Diseases, in Germany about cancer-related out-of-pocket costs, income loss, distress, and quality of life. Multiple linear regression analysis was performed to demonstrate the effects of economic deterioration on patients' quality of life and distress.
results81% (n = 199) of the patients reported out-of-pocket costs, and 37% (n = 92) income loss as a consequence of their disease. While monthly out-of-pocket costs did not exceed 200€ in 77% of affected patients, 24% of those with income losses reported losing more than 1.200€ per month. High financial loss relative to income was significantly associated with patients' reporting a worse quality of life (p < .05) and more distress (p < .05).
conclusionsFinancial toxicity in third-party payer health care systems like Germany is caused rather by income loss than by co-payments. Distress and reduced quality of life due to financial problems seem to amplify the burden that already results from a cancer diagnosis and treatment. If confirmed at a broader scale, there is a need for targeted support measures at the individual and system level.
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