Contemporary patterns of financial toxicity among patients with rheumatologic disease in the United States Journal Article


Authors: Amen, T. B.; Dee, E. C.; Jain, B.; Batter, S.; Jain, U.; Bajaj, S. S.; Varady, N. H.; Amen, L. J.; Goodman, S. M.
Article Title: Contemporary patterns of financial toxicity among patients with rheumatologic disease in the United States
Abstract: Background/Objective Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors. Methods The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease. Patient demographics and self-reported financial metrics were collected or calculated including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) nonadherence. Multivariable logistic regressions were used to assess for factors associated with increased financial hardship. Results During the study period, 20.2% of 41,502 patients with rheumatologic disease faced some degree of financial hardship due to medical bills, 55.0% of whom could not pay those bills. Rheumatologic disease was associated with higher odds of financial hardship from medical bills (adjusted odds ratio, 1.29; 95% confidence interval, 1.22-1.36; p < 0.001) with similar trends for patients suffering from financial distress, food insecurity, and CRM nonadherence (p < 0.001 for all). Financial hardship among patients with rheumatologic disease was associated with being younger, male, Black, and uninsured (p < 0.001 for all). Conclusion In this nationally representative study, we found that a substantial proportion of adults with rheumatologic disease in the United States struggled with paying their medical bills and suffered from food insecurity and CRM nonadherence. National health care efforts and guided public policy should be pursued to help ease the burden of financial hardship for these patients. © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: adult; aged; middle aged; young adult; major clinical study; united states; age; self report; health care cost; economics; health expenditures; cross-sectional study; cross-sectional studies; epidemiology; gender; cost of illness; medication adherence; race; demographics; rheumatic disease; medication compliance; humans; human; male; female; article; black person; food insecurity; medically uninsured; financial toxicity; metric system; rheumatic diseases; financial stress; rheumatologic disease; medical bills
Journal Title: Journal of Clinical Rheumatology
Volume: 30
Issue: 6
ISSN: 1076-1608
Publisher: Lippincott Williams & Wilkins  
Date Published: 2024-09-01
Start Page: 223
End Page: 228
Language: English
DOI: 10.1097/rhu.0000000000002110
PUBMED: 38976618
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Edward Christopher Dee
    253 Dee