For years, cancer has been one of the leading causes of death. It not only threatens people’s lives but also places a heavy financial burden on patients and their families—imagine endless expenses, severe losses, and an uncertain future.
This reality is precisely what the term “financial toxicity” describes—it outlines the harsh reality when the rising costs of oncological treatment destroy a family’s stability just as much as the disease itself.
Studies conducted in North America, Western Europe, and Asia have shown that financial difficulties often lead to treatment discontinuation, lower survival rates, and severe psychological stress (Zafar et al., 2013; Carrera et al., 2018; Khera et al., 2014). The World Health Organization also warns that medical expenses that families cannot cover are a leading cause of impoverishment for vulnerable groups.
The Georgian Reflection of a Global Problem
Despite the constant discussion of the financial strain of cancer treatment, the real situation of oncology patients in low- and middle-income countries is often not yet adequately studied.
In Georgia, where the healthcare system is undergoing a difficult path of reform and socio-economic inequality is acutely felt, reliable data on the financial impact of cancer is alarmingly scarce. This huge gap demanded urgent research.
In this global context, the situation in Georgia was highlighted by Tamar Kakhniashvili, Ivane Kiladze, and Nino Okribelashvili. Their work was published in the scientific journal The Sage – Cancer Control. The study clearly shows the price Georgian oncology patients have to pay to survive, how they try to cope with difficulties, and the scale of out-of-pocket expenses they incur.
In an interview with Medscriptum, Tamar Kakhniashvili spoke about the study’s objectives and the steps that must be taken to solve the “silent” crisis of financial toxicity.
Salome Chkheidze: Your research is one of the first in Georgia to confirm the hidden financial toxicity with real statistical data. What kind of difficulties do oncology patients face, and what do you think is behind this phenomenon?
Tamar Kakhniashvili Oncological disease treatment is very expensive, and financial toxicity is a significant challenge in developed countries. This problem is even more relevant in developing countries like Georgia. Our study was conducted in seven hospitals across four cities in Georgia and included 181 oncology patients. The results showed that despite the universal health insurance that has been in effect in our country for many years and covers almost the entire treatment, patients still face various financial problems.
In the majority of cases (74.5%), oncological treatment is a significant financial burden for patients and their families.
71% of patients have additional expenses that they cover out of their own pocket (“out-of-pocket expenses”).
44.2% of the study participants reported that they had to take out a loan at least once during the diagnosis and treatment process of the oncological disease.
One-third (33.5%) of employed patients also reported work-related problems associated with cancer treatment.
Salome Chkheidze: Do patients avoid taking loans or asking for help due to social stigma?
Tamar Kakhniashvili The patients we surveyed did not talk about such problems.
Salome Chkheidze: Did the study show any long-term or unexpected social consequences?
Tamar Kakhniashvili A particularly unexpected finding was the fact that almost half of the patients had to take out a loan for diagnosis and treatment. Younger patients had to take out loans more often than older ones. For 41% of the patients, cancer treatment is a “heavy” financial burden today.
Salome Chkheidze: As you mentioned, one-third of employed oncology patients also faced problems at work during treatment. What labor policy shortcomings exacerbate the financial burden on oncology patients in Georgia?
Tamar Kakhniashvili We think that labor contracts need to be improved and patients’ labor rights need to be protected. Private insurance companies should also take on more responsibility.
Salome Chkheidze: Why did you decide to conduct this research? Was there any specific patient’s story or observation of these problems that led you to speak openly about the financial difficulties of oncology patients?
Tamar Kakhniashvili or many years, we have been working with oncology patients—I, as an oncology psychologist and co-author of the study, and Ivane Kiladze, as a clinical oncologist. In our daily practical experience, we have had many cases where patients were unable to undergo expensive but necessary diagnostics or treatment. In addition, they have problems at work, in their families, and in society. Such cases and the fact that there are no scientific studies in this area in Georgia were the reasons for conducting this research.
Salome Chkheidze: What changes do you expect after this study? Could it influence both the healthcare sector and public awareness, and what are your future plans to keep this issue relevant?
Tamar Kakhniashvili In Georgia, cancer treatment is a significant financial burden for many patients, which often leads to accumulating debt and difficulties with employment. These findings indicate that financial assistance programs must be improved so that patients can both fund their treatment and, at the same time, avoid economic difficulties.
The results of the study also provide important recommendations for those working on healthcare policy, specifically: expanding universal healthcare to cover initial diagnostic and laboratory tests, as well as medications; reducing patients’ out-of-pocket expenses; implementing needs-based financial assistance for low-income patients; and strengthening job retention and income support during treatment.
This is the first study to reflect the financial difficulties caused by a cancer diagnosis at a national level. The results send a clear signal to representatives of various sectors of the healthcare field: the “burden” of cancer extends beyond the hospital walls.
See the full article on the following link: https://journals.sagepub.com
