title: Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: results from a multicenter pilot study.
abstract: Hematopoietic cell transplantation (HCT) is a procedure that can significantly influence the socioeconomic wellbeing of patients, caregivers and their families. Among 30 allogeneic HCT recipients and their caregivers enrolled on a pilot study evaluating the feasibility of studying financial impact of HCT, 16 agreed to participate in the long-term phase, completed a baseline questionnaire and received phone interviews at 6, 12, 18 and 24 months post HCT. Analyses showed that by 2 years post HCT, 54% of patients who previously contributed to household earnings had not returned to work and 80% of patients/caregivers reported transplant as having moderate to great impact on household income. However, patients' levels of confidence in their abilities to meet household financial obligations increased from baseline to 2 years. A relatively large proportion of patients reported inability to pay for medical care through this time period. Case studies demonstrated that patients' individual perceptions of the financial impact of HCT varies considerably, regardless of actual income. We demonstrate the feasibility of conducting a study to evaluate the financial impact of allogeneic HCT through 2 years post transplantation. Some patients/caregivers continue to experience a significant long-term financial burden after this procedure. Our study lays the foundation for a larger evaluation of patient/caregiver financial burden associated with HCT.
authors.affiliation: National Marrow Donor Program, Minneapolis, MN, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Denzen
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: V
authors.initials: V
authors.lastname: Thao
authors.affiliation: Blood and Marrow Transplantation Program, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: T
authors.initials: T
authors.lastname: Hahn
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Blood and Marrow Transplantation Program, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: McCarthy
authors.affiliation: Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Rizzo
authors.affiliation: Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ammi
authors.affiliation: Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
authors.forename: R
authors.initials: R
authors.lastname: Drexler
authors.affiliation: Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Flesch
authors.affiliation: National Marrow Donor Program, Minneapolis, MN, USA.
authors.forename: H
authors.initials: H
authors.lastname: James
authors.affiliation: Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
authors.forename: N
authors.initials: N
authors.lastname: Omondi
authors.affiliation: National Marrow Donor Program, Minneapolis, MN, USA.
authors.forename: E
authors.initials: E
authors.lastname: Murphy
authors.affiliation: National Marrow Donor Program, Minneapolis, MN, USA.
authors.forename: K
authors.initials: K
authors.lastname: Pederson
authors.affiliation: Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Majhail
mesh_terms: D017028:Caregivers / Q000191:economics*; D017281:Cost of Illness; D004651:Employment / Q000191:economics; D005192:Family Health / Q000191:economics; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics*; D006801:Humans; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous / Q000191:economics