Impact of lung cancer on health-related quality of life, financial toxicity and household economics in patients from the public and the private healthcare sector in Argentina

Abstract

Abstract Purpose: Non-small cell lung cancer (NSCLC) is Argentina's first cause of cancer death. Most patients have an advanced stage at diagnosis, with poor expected survival. This study aimed to characterize the health-related quality of life and economic impact of patients treated in the private healthcare sector and compare it to that of the public sector. Methods: We undertook an observational cross-sectional study that extended a previous study to a referral private center in Argentina. Outcomes included the EuroQol EQ-5D-3L (to assess health-related quality of life), COST (financial toxicity instrument), WPAI-GH (to assess productivity loss), and out-of-pocket expenses in adults diagnosed with NSCLC. Results: We included 30 consecutive patients from a private healthcare center (July 2021 to March 2022), totaling 131 patients (N = 101 from previous public study). The whole sample had low quality of life, and relevant economic impact. Patients in the private healthcare sector showed lower disease severity, higher educational level and household income. In addition, private healthcare system patients showed higher utility (0.77 vs. 0.73; p = 0.049) and lower impairment of daily activities (41% vs. 59%; p = 0.014). Private health system patients showed also lower financial toxicity as measured by the COST score (23.9 vs. 20.14; p = 0.036) but showed no differences when financial toxicity was assessed as a dichotomic variable. Conclusions: Though patients with NSCLC treated in a private healthcare center in Argentina showed a significant health-related quality of life and economic impact, this impact was smaller than the one observed in publicly funded hospitals.