title: The impact of outpatient systemic anti-cancer treatment on patient costs and work practices.
abstract: BACKGROUND
  There is extensive focus on the rising costs of healthcare. However, for patients undergoing cancer treatment, there are additional personal costs, which are poorly characterised.
  
  
  OBJECTIVE
  To qualify indirect costs during anti-cancer therapy in a designated Irish cancer centre.
  
  
  METHODS
  An anonymous questionnaire collected demographic data, current work practice, and personal expenditure on regular and non-regular indirect costs during treatment. Differences between groups of interest were compared using the Mann-Whitney U test.
  
  
  RESULTS
  In total, there were 151 responders of median age 58 years; 60 % were female and 74 % were not working. Breast cancer (29 %) was the most frequent diagnosis. Indirect costs totalled a median of €1138 (range €21.60-€7089.84) per patient, with median monthly outgoings of €354. The greatest median monthly costs were hair accessories (€400), transportation (€65), and complementary therapies (€55). The majority (74 %) of patients used a car and median monthly fuel expenditure was €31 (range €1.44-€463.32). Women spent more money during treatment (€1617) than men (€974, p = 0.00128). In addition, median monthly expenditure was greater for those less than 50 years old (€1621 vs €1105; p = 0.04236), those who lived greater than 25 km away (€2015 vs €1078; p = 0.00008) and those without a medical card (€2023 vs €961; p = 0.00024).
  
  
  CONCLUSIONS
  This study highlights the need for greater awareness of indirect expenditures associated with systemic anti-cancer therapy in Ireland.
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland. collinsdearbhaile1@gmail.com.
authors: D C
authors: DC
authors: Collins
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland.
authors: M
authors: M
authors: Coghlan
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland.
authors: B T
authors: BT
authors: Hennessy
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland.
authors: L
authors: L
authors: Grogan
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland.
authors: P G
authors: PG
authors: Morris
authors: Cancer Clinical Trials and Research Unit, RCSI Hospitals Group, Beaumont Hospital, Dublin 9, Ireland.
authors: O S
authors: OS
authors: Breathnach
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D001943:Breast Neoplasms / Q000191:economics / Q000628:therapy; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000628:therapy*; D010045:Outpatients; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anti-cancer medicines; Health economics; Indirect costs; Personal expenditure; Work practices