OBJECTIVES: Financial burden perceived by patients with cancer is often underappreciated in countries with universal coverage. This study aimed to characterize the association between perceived financial burden and health-related quality of life (HRQoL) among patients with cancer in Finland.

METHODS: This was a cross-sectional survey of 504 patients with cancer enrolled trough community pharmacies and patient organizations between April 2019 and September 2020. Perceived financial burden was assessed with a question “Has cancer negatively impacted your financial situation?” (answer choices: yes, considerably; yes, to some extent; no; cannot say). HRQoL was measured with the generic 15D HRQoL instrument including the following dimensions: mobility, sight, breathing, sleeping, eating, speaking, secretion, daily activities, mentality, aliments and symptoms, depression, distress, vitality, and sexual activity. The association between perceived financial burden and 15D score was analyzed with linear regression adjusted for gender, time since diagnosis, cancer type and progression, need for assistance, net income, and private cancer insurance.

RESULTS: Of all respondents, 79% were women; 58% had been diagnosed with cancer within the past two years and 8.3% over 10 years ago. Almost every second (47%) respondent perceived that cancer had negatively impacted their financial situation at least to some extent. The mean 15D score was 0.76 (standard deviation [SD]=0.11) in patients perceiving considerable burden (n=135), 0.82 (SD=0.10) in those with some burden (n=220) and 0.89 (SD=0.07) with no burden (n=132). Furthermore, perceived financial burden was inversely associated with the mean 15D score in multivariable regression model (beta coefficient for considerable vs. no burden: -0.09, p<0.0001; some vs. no burden: -0.05, p<0.0001) and with each dimension of 15D.

CONCLUSIONS: Financial burden is a concern for a significant proportion of patients with cancer. Most importantly, the perceived financial burden seems to be associated with reduced HRQoL independent of the patient’s net income.