DISP-02. Financial toxicity: frequency, impact, and unmet needs in primary brain malignancy

Financial toxicity, representing the burden and distress of healthcare costs to patients and families, is high within medical oncology. Oncology nurse navigation (ONN) plays an important role in guiding cancer patients toward resources to minimize financial toxicity, but assessment tools remain limited. Our aim was to evaluate the extent and impact of financial toxicity on primary brain malignancy. We assessed financial toxicity experienced by 47 consecutive primary brain cancer patients at initial neuro-oncology consult following surgery over a 6-month period of 2024. ONN created a consensus questionnaire investigating demographic variables, financial security, medical costs, and openness to financial resources. Descriptive statistics were used for analysis. This was a quality improvement project exempt from IRB approval. Of the patients, 57% of patients were female, 89% were white, 77% were married, and 77% had high-grade gliomas. Fifty-one percent were over age 60, while 15% were younger than 40. Thirty- two percent were employed or on medical leave, 35% were retired, and 34% were disabled. Ninety-four percent had medical insurance. Fifty-seven percent reported at least some financial stress and 26% reported an instance of care avoidance due to cost. Forty percent identified a need for financial assistance and 17% reported transportation barriers. Eighty-six percent were open to discussing financial needs with their nurse navigator, while 55% sought referral to a financial navigator, social worker, or both. Assessment of financial toxicity in neuro-oncology patients offered actionable work for ONN. Notably, despite 94% having medical insurance, 70% expressed a need for financial assistance and requested referrals, highlighting a critical gap in support.