Financial Toxicity in Cancer Care

Financial toxicity describes the adverse economic effects that arise when individuals and households face the high costs of cancer treatment. It encompasses direct medical expenses such as consultations, therapies and hospitalisation, as well as indirect costs including travel, accommodation and loss of income due to reduced work capacity. The interplay between medical bills and diminished earnings can lead to substantial distress, forcing patients to delay or forgo essential care, draw on savings, incur debt or sacrifice basic living expenses. While high-income settings may offer comprehensive insurance schemes, co-payments and benefit gaps still expose many to hardship. In low- and middle-income regions, where public coverage is often limited, cancer can precipitate catastrophic spending that drives families into poverty. Beyond individual suffering, financial toxicity imposes a wider societal toll by undermining workforce participation, exacerbating health disparities and straining social protection systems. Recent work has highlighted the need for standardised measurement tools to quantify economic burden, and for policy interventions that combine cost containment with targeted support for vulnerable groups. Integrating financial navigation into clinical practice and adopting strategies such as early diagnosis and value-based pricing may help mitigate the dual medical and economic challenges of cancer care on a global scale.

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Financial Toxicity in Cancer Care publication trend

The graph below shows the total number of articles in financial toxicity in cancer care across all publications each year (not limited to Nature Index journals).

Technical terms

Financial toxicity: The financial hardship experienced by patients due to the cost of cancer treatment and its associated economic consequences.

Out-of-pocket costs: Direct payments made by patients for medical and non-medical services not covered by insurance or public funding.

Catastrophic health expenditure: Spending on health care that exceeds a specified threshold of household income, potentially leading to severe financial distress.

Macroeconomic burden: The overall impact of disease-related costs on a national or global economy, including effects on productivity and gross domestic product.

Socioeconomic status: An individual’s or group’s social and economic standing, often measured by income, education and occupation.

References

1. Estimates and Projections of the Global Economic Cost of 29 Cancers in 204 Countries and Territories From 2020 to 2050. JAMA Oncology (2023).
2. Forgoing medical care because of cost. Cancer (2010).
3. Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries. BMC Medicine (2015).
4. Financial toxicity and employment status in cancer survivors. A systematic literature review. Supportive Care in Cancer (2020).
5. The Out-of-Pocket Cost Burden of Cancer Care—A Systematic Literature Review. Current Oncology (2021).