Financial toxicity among cancer patients in Slovenia

Skubic, Marjeta (author), Vöröš, Katja (author), Bavdaž, Mojca (author), Došenović Bonča, Petra (author), Perhavec, Andraž (author), Redek, Tjaša (author), Ratoša, Ivica (author), Zobec Logar, Helena Barbara (author)

Background: The ageing population, increasing medical costs and a number of newly diagnosed cancer cases among the working population are increasing the financial burden on healthcare systems. The extent of financial toxicity in Slovenian patients has been insufficiently researched, as has its impact on quality of life (QoL). Methods: To evaluate financial toxicity, the Functional Assessment of Chronic Illness Therapy (COST-FACIT) questionnaire was translated into Slovenian, validated, introduced and compared with the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Additional questions were incorporated into the questionnaire to further quantify and objectify financial toxicity. The study was cross-sectional. The statistical analysis was based on descriptive and inferential statistics and exploratory data analysis. Results: Out of 590 analysed participants, financial toxicity was absent in 57.2% but present at mild to moderate levels in 42.8%. Key risk factors included lower income, age ≤ 65, employment, active oncologic treatment, rural residence and religious affiliation. Post hoc analyses showed higher financial toxicity in those with ≤ 600 EUR monthly income, employed patients and spiritual individuals, while cancer type showed no significant differences. The correlation between financial toxicity and QoL was mild. Objective measures of financial toxicity include direct costs (e.g., transportation, supplements and medical devices) and indirect costs (e.g., loss of income) associated with disease and treatment, which burdened more than 40% of the studied population. Conclusions: The COST-FACIT proved to be a helpful screening tool for identifying patients at risk, even in a public healthcare system such as the Slovenian system. On average, financial toxicity is low due to the publicly funded financial system covering the treatment and rehabilitation of malignant diseases. The age structure of cancer patients and secure pension income further contribute to this outcome.

• Language: English
• Keywords: cancer burden, cancer patients, COST-FACIT, EORTC QLQ-C30, financial burden, financial toxicity, quality of life
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: EF - School of Economics and Business; MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: 13 str.
• Numbering: Vol. 14, iss. 8, article no. e70891
• PID: 20.500.12556/RUL-172604
• UDC: 614
• ISSN on article: 2045-7634
• DOI: 10.1002/cam4.70891
• COBISS.SI-ID: 234081539
• Publication date in RUL: 09.09.2025

Record is a part of a journal

• Title: Cancer medicine
• Publisher: John Wiley & Sons Ltd
• ISSN: 2045-7634
• COBISS.SI-ID: 519144729

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: zdravstvo, bolezni, onkološki bolniki, finančna stiska, življenjski stroški