COVID-19 Pandemic-Era Financial Burden High in Survivors of Blood and Marrow Transplantation

Out-of-pocket medical costs were high for survivors of blood or marrow transplantation (BMT) when measured during a period of the COVID-19 pandemic between October 2020 and November 2021. This is according to study results published in the Journal of Clinical Oncology.

“We determined that during the COVID-19 pandemic, financial burden was prevalent among adult BMT survivors and high out-of-pocket medical costs were associated with high financial burden,” the study investigators wrote in their report. The investigators had sought to determine how survivors of BMT have been impacted financially during the COVID-19 pandemic.

The study included adult participants of a survey of the BMT Survivor Study (BMTSS), which had been a retrospective cohort study that included prospective follow-up. The BMTSS evaluated numerous characteristics and outcomes in survivors of BMT.

The current study involved a survey to evaluate out-of-pocket medical costs and financial burden in BMTSS participants during the COVID-19 pandemic, as well as these factors for a sibling comparison group. High out-of-pocket medical costs were characterized by having medical expenses that totaled 10% or more of annual household income.

The protracted nature of financial stress in patients with cancer makes it critical to follow this vulnerable population for long-term consequences

The current analysis involved 2370 survivors of BMT and 750 of their siblings. Among survivors of BMT, it was reported that 11.3% had high out-of-pocket medical costs, compared with 3.1% of siblings (adjusted odds ratio [aOR], 2.88; 95% CI, 1.84-4.50). Among survivors, several factors were linked to having high out-of-pocket medical costs, such as demographic and clinical characteristics, chronic health conditions, employment status during the pandemic, and others.  

High out-of-pocket medical costs in BMT survivors were linked to several indicators of financial challenge. Some of these included having difficulty with paying medical bills (aOR, 10.57; 95% CI, 7.39-15.11), taking a lower medication dose than prescribed (aOR, 4.99; 95%CI, 3.23-7.70), deferring medical care (aOR, 4.93; 95% CI, 3.71-6.55), thinking about filing bankruptcy (aOR, 3.80; 95% CI, 2.14-6.73), and others.

The investigators concluded that financial burden in association with high out-of-pocket medical costs has appeared common in BMT survivors of this study during the COVID-19 pandemic, and these costs could lead to choices with negative impacts on health. “The protracted nature of financial stress in patients with cancer makes it critical to follow this vulnerable population for long-term consequences,” the study investigators wrote in their report.

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

This article originally appeared on Hematology Advisor


Bhatia S, Dai C, Hageman L, et al. Financial burden in blood or marrow transplantation survivors during the COVID-19 pandemic: a BMTSS report. J Clin Oncol. 2023;41(5):1011-1022. doi:10.1200/JCO.22.00461