An exploratory qualitative study on financial toxicity in cancer patients of Pakistan: implications, patient coping strategies and future direction

OBJECTIVE: This study aims to explore the impact of financial toxicity (FT) faced by cancer patients in Bahawalpur, Pakistan, identify their coping strategies and provide patient-driven recommendations to mitigate the FT. DESIGN: A qualitative study design was used, and thematic analysis was employed to analyse the data. SETTING: Patients were selected from two tertiary care hospitals located in Bahawalpur, Pakistan. PARTICIPANT: Thirty patients were selected using a purposive and convenience sampling method. Data were collected between April and June 2024. Patients who provided consent, were 18 years or older and were receiving cancer treatment were included in the study. RESULTS: Most participants were between 40 and 60 years old, and 66.6% were male. The study highlights severe FT, characterised by financial instability, psychological distress and family lifestyle disruptions. Patients employed various strategies, such as adjusting healthcare decisions, mobilising financial resources and seeking financial aid to cover treatment costs. Novel insights revealed the inadequacy of existing government health card programmes, which focus on direct medical expenses but fail to cover indirect costs, further exacerbating FT. Patients reported significant challenges in accessing government aid programmes due to administrative barriers. Participants highlighted the need for additional support mechanisms to address these gaps effectively, including enhanced accessibility, broadening financial assistance and integrated financial counselling. CONCLUSION: This study is the first to explore FT in Pakistan's healthcare system. It reveals gaps in support mechanisms and highlights the need for comprehensive policy interventions. Addressing these challenges holistically can improve patient outcomes and quality of life.