Women and Younger Adults With Inflammatory Bowel Disease are at Greater Risk of Financial Toxicity From Inflammatory Bowel Disease.

INTRODUCTION

Financial toxicity, the combined objective burden and subjective distress that affects patients' medical care, is not well described in patients with inflammatory bowel disease (IBD). We aimed to characterize financial toxicity in patients with IBD.

METHODS

We designed and administered a deidentified survey to patients with IBD. The primary outcome, financial toxicity, was defined as a score <22 on the Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) scale, a validated measure. We constructed multivariable logistic regression models to evaluate associations adjusting for age, sex, race, type of IBD, IBD medications, household income, and education level.

RESULTS

Respondents (n = 669) had a median age of 49 years, were 62% female and 92% White. 52% were currently treated with advanced IBD-therapy, and 58% reported IBD in remission/minimal activity. 53% were employed full-time. 61% had an annual household income ≥$100,000. 69% had private insurance, and 31% had Medicare. 21% reported trouble paying medical bills in the past year; 34% of working adults missed work in the past 7 days because of IBD. 39% experienced financial toxicity. Adjusting for confounders, adults aged younger than 65 years were more likely to experience toxicity than older adults (adjusted odds ratio [aOR]: 6.78, 95% CI: 2.60-17.65). Those with education less than a Bachelor Degree (aOR: 2.73, 95% CI: 1.70-4.37), annual household income <$60,000 (aOR: 3.71, 95% CI: 2.14-6.42), and women were more likely to experience financial toxicity (aOR: 1.90; 95% CI: 1.28-2.81).

DISCUSSION: Financial toxicity was prevalent among patients with IBD, particularly among younger adults, those with lower income and education, and women. Inquiring about financial toxicity should be incorporated into IBD clinical practice.