Health-related Quality of life, Financial Toxicity, Productivity Loss and Catastrophic Health Expenditures After Lung Cancer Diagnosis in Argentina

Objective: About 12,000 people are diagnosed with lung cancer (LC) each year in Argentina, and the diagnosis has a significant personal and family. The objective of this study was to characterize the Health-Related Quality of Life (HRQoL) and the economic impact in patients with LC and in their households. Methods: Observational cross-sectional study, through validated structured questionnaires to patients with a diagnosis of Non-Small Cell Lung Cancer (NSCLC) in two referral public health care centers in Argentina. Questionnaries used: Health-Related Quality of life (EuroQol EQ-5D-3L questionnaire); financial toxicity (COST questionnaire); productivity loss (WPAI-GH, Work Productivity and Activity Impairment Questionnaire: General Health), and out-of-pocket expenses. Results: We included 101 consecutive patients (mean age 67.5 years; 55.4% men; 57.4% with advanced disease -stage III/IV-). The mean EQ-VAS was 68.8 (SD:18.3), with 82.2% describing fair or poor health. The most affected dimensions were anxiety/depression, pain, and activities of daily living. Patients reported an average 59% decrease in their ability to perform regular daily activities as measured by WPAI-GH. 54.5% reported a reduction in income due to the disease, and 19.8% lost their jobs. The annual economic productivity loss was estimated at USD 2,465 per person. 70.3%) of patients reported financial toxicity. The average out-of-pocket expenditure was USD 100.38 per person per month, which represented 18.5% of household income. Catastrophic expenditures were present in 37.1% of households. When performing subgroup analysis by disease severity, all outcomes were worse in the subpopulation with advanced disease. Conclusions Patients with NSCLC treated in public hospitals in Argentina have significant health-related quality of life and economic impact, worsening in patients with advanced disease.