Javier Valero Elizondo, MD, MPH- Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults ...

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Dr. Javier Valero-Elizondo works as a Research Associate at the Center for Outcomes Research at the Houston Methodist Research Institute. In this video Dr. Valero-Elizondo speaks about Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States.

Link to Abstract-
https://www.jacc.org/doi/10.1016/j.jaccao.2021.02.006


Abstract

Background
Financial toxicity (FT) is a well-known adverse effect of the high costs of cancer treatment. According to recent studies, a considerable proportion of people with atherosclerotic cardiovascular disease (ASCVD) suffer from FT and its effects.

Objectives
The goal of this study was to compare FT in those who had neither ASCVD nor cancer, as well as those who had ASCVD but not cancer, cancer but not ASCVD, and both ASCVD and cancer.

Methods
We identified persons with self-reported ASCVD and/or cancer from the National Health Interview Survey between 2013 and 2018, stratifying data by nonelderly (age 65 years) and elderly (age 65 years). Any trouble paying medical bills, substantial financial distress, cost-related medication nonadherence, food insecurity, and/or foregone/delayed care due to cost were all indicators of FT.

Results
When comparing individuals with ASCVD to those with cancer, the prevalence of FT was higher (54 percent vs. 41 percent; p 0.001). In adjusted analyses, those with ASCVD were more likely to have any difficulty paying medical bills (OR: 1.22; 95 percent confidence interval [CI]: 1.09 to 1.36), inability to pay bills (OR: 1.25; 95 percent CI: 1.04 to 1.50), cost-related medication nonadherence (OR: 1.28; 95 percent CI: 1.08 to 1.51), food insecurity (OR: 1.39; 95 percent CI: 1.17 to 1.64), and foregone/delayed care (OR: 1.17; 95 percent CI: 1.01 to 1.36). When comparing individuals with ASCVD and those with both ASCVD and cancer to those without cancer, the presence of three of these variables was considerably greater (23 percent vs. 30 percent vs. 13 percent, respectively; p 0.001). In the older population, the results were comparable.

Conclusions
Our findings show that FT is more common in individuals with ASCVD than in those with cancer, with those with both diseases having the highest burden.