‘The bills that were coming in…’: out of pocket costs during relocation for specialist treatment for haematological malignancies
- Pam McGrath
- Supportive Care in Cancer
We describe a method we developed for estimating cancer costs from the perspective of patients and caregivers and evidence supporting validity of estimates obtained. To increase validity, interview questions were anchored to treatments; costs were divided into their components; most questions focused on facts; and the research team combined responses into cost estimates. Evidence for validity comes from a prospective study of breast cancer costs using this method. Estimates obtained using interview responses were similar to those from independent sources. Women reported being reimbursed $205 on average for prosthesis (government reimbursement = $200); paying $15.48 per night at cancer lodge (average rate = $17.52); receiving government illness insurance for 14.6 weeks at 53% of usual salary (governmental program covers 15 weeks at 55%). A priori hypotheses about relations of costs with other characteristics were also confirmed. For example, patients’ weekly travel costs increased as a function of distance from the radiotherapy center, with patients living <25, 25–49 and ≥50 km away spending $54, $141 and $240, respectively (P < .0001); and the proportion of annual salary lost was 37% for self-employed workers compared to 18% for employees (P < .0001). Evidence to date supports the validity of estimates obtained using this method.