Staff View: Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study

Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study

Background Complementary medicine, which refers to therapies that are not part of conventional medicine, comprising both evidence-based and non-evidence-based interventions, is increasingly used following a diagnosis of cancer. We aimed to investigate out-of-pocket spending patterns on complementary...

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Main Authors:	Kong, Yek-Ching, Kimman, Merel, Subramaniam, ShriDevi, Yip, Cheng-Har, Jan, Stephen, Aung, Soe, Khoa, Mai Trong, Ngelangel, Corazon A., Nyein, Htun Lwin, Sangrajrang, Suleeporn, Tanabodee, Jitraporn, Bhoo-Pathy, Nirmala
Format:	Article
Published:	Elsevier Science Ltd 2022
Subjects:	RA Public aspects of medicine
Online Access:	http://eprints.um.edu.my/32763/
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spelling	my.um.eprints.327632022-04-22T07:02:26Z http://eprints.um.edu.my/32763/ Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study Kong, Yek-Ching Kimman, Merel Subramaniam, ShriDevi Yip, Cheng-Har Jan, Stephen Aung, Soe Khoa, Mai Trong Ngelangel, Corazon A. Nyein, Htun Lwin Sangrajrang, Suleeporn Tanabodee, Jitraporn Bhoo-Pathy, Nirmala RA Public aspects of medicine Background Complementary medicine, which refers to therapies that are not part of conventional medicine, comprising both evidence-based and non-evidence-based interventions, is increasingly used following a diagnosis of cancer. We aimed to investigate out-of-pocket spending patterns on complementary medicine and its association with adverse financial outcomes following cancer in middle-income countries in southeast Asia. Methods In this prospective cohort study, data on newly diagnosed patients with cancer were derived from the ASEAN Costs in Oncology (ACTION) cohort study, a prospective longitudinal study in 47 centres located in eight countries in southeast Asia. The ACTION study measured household expenditures on complementary medicine in the immediate year after cancer diagnosis. Participants were given cost diaries at baseline to record illness-related payments that were directly incurred and not reimbursed by insurance over the 12-month period after study recruitment. We assessed incidence of financial catastrophe (out-of-pocket cancer-related costs >= 30% of annual household income), medical impoverishment (reduction in annual household income to below poverty line following subtraction of out-of-pocket cancer-related costs), and economic hardship (inability to make necessary household payments) at 1 year. Findings Between March, 2012, and September, 2013, 9513 participants were recruited into the ACTION cohort study, of whom 4754 (50.0%) participants were included in this analysis. Out-of-pocket expenditures on complementary medicine were reported by 1233 households. These payments constituted 8.6% of the annual total out-of-pocket health costs in lower-middle-income countries and 42.9% in upper-middle-income countries. Expenditures on complementary medicine significantly increased risks of financial catastrophe (adjusted odds ratio 1.52 95% CI 1.23-1.88]) and medical impoverishment (1.75 1.36-2.24]) at 12 months in upper-middle-income countries only. However, the risks were significantly higher for economically disadvantaged households, irrespective of country income group. Interpretation Integration of evidence-supported complementary therapies into mainstream cancer care, along with interventions to address use of non-evidence-based complementary medicine, might help alleviate any associated adverse financial impacts. Elsevier Science Ltd 2022-03 Article PeerReviewed Kong, Yek-Ching and Kimman, Merel and Subramaniam, ShriDevi and Yip, Cheng-Har and Jan, Stephen and Aung, Soe and Khoa, Mai Trong and Ngelangel, Corazon A. and Nyein, Htun Lwin and Sangrajrang, Suleeporn and Tanabodee, Jitraporn and Bhoo-Pathy, Nirmala (2022) Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study. The Lancet Global Health, 10 (3). E416-E428. ISSN 2214-109X,
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	RA Public aspects of medicine
spellingShingle	RA Public aspects of medicine Kong, Yek-Ching Kimman, Merel Subramaniam, ShriDevi Yip, Cheng-Har Jan, Stephen Aung, Soe Khoa, Mai Trong Ngelangel, Corazon A. Nyein, Htun Lwin Sangrajrang, Suleeporn Tanabodee, Jitraporn Bhoo-Pathy, Nirmala Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
description	Background Complementary medicine, which refers to therapies that are not part of conventional medicine, comprising both evidence-based and non-evidence-based interventions, is increasingly used following a diagnosis of cancer. We aimed to investigate out-of-pocket spending patterns on complementary medicine and its association with adverse financial outcomes following cancer in middle-income countries in southeast Asia. Methods In this prospective cohort study, data on newly diagnosed patients with cancer were derived from the ASEAN Costs in Oncology (ACTION) cohort study, a prospective longitudinal study in 47 centres located in eight countries in southeast Asia. The ACTION study measured household expenditures on complementary medicine in the immediate year after cancer diagnosis. Participants were given cost diaries at baseline to record illness-related payments that were directly incurred and not reimbursed by insurance over the 12-month period after study recruitment. We assessed incidence of financial catastrophe (out-of-pocket cancer-related costs >= 30% of annual household income), medical impoverishment (reduction in annual household income to below poverty line following subtraction of out-of-pocket cancer-related costs), and economic hardship (inability to make necessary household payments) at 1 year. Findings Between March, 2012, and September, 2013, 9513 participants were recruited into the ACTION cohort study, of whom 4754 (50.0%) participants were included in this analysis. Out-of-pocket expenditures on complementary medicine were reported by 1233 households. These payments constituted 8.6% of the annual total out-of-pocket health costs in lower-middle-income countries and 42.9% in upper-middle-income countries. Expenditures on complementary medicine significantly increased risks of financial catastrophe (adjusted odds ratio 1.52 95% CI 1.23-1.88]) and medical impoverishment (1.75 1.36-2.24]) at 12 months in upper-middle-income countries only. However, the risks were significantly higher for economically disadvantaged households, irrespective of country income group. Interpretation Integration of evidence-supported complementary therapies into mainstream cancer care, along with interventions to address use of non-evidence-based complementary medicine, might help alleviate any associated adverse financial impacts.
format	Article
author	Kong, Yek-Ching Kimman, Merel Subramaniam, ShriDevi Yip, Cheng-Har Jan, Stephen Aung, Soe Khoa, Mai Trong Ngelangel, Corazon A. Nyein, Htun Lwin Sangrajrang, Suleeporn Tanabodee, Jitraporn Bhoo-Pathy, Nirmala
author_facet	Kong, Yek-Ching Kimman, Merel Subramaniam, ShriDevi Yip, Cheng-Har Jan, Stephen Aung, Soe Khoa, Mai Trong Ngelangel, Corazon A. Nyein, Htun Lwin Sangrajrang, Suleeporn Tanabodee, Jitraporn Bhoo-Pathy, Nirmala
author_sort	Kong, Yek-Ching
title	Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
title_short	Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
title_full	Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
title_fullStr	Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
title_full_unstemmed	Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study
title_sort	out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: a prospective cohort study
publisher	Elsevier Science Ltd
publishDate	2022
url	http://eprints.um.edu.my/32763/
_version_	1735409584425664512
score	13.211869

Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast asia: A prospective cohort study

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