Demystifying financial toxicity: the COST scale

On the cancer treatment journey, patients face not only physical challenges but also a hidden economic burden known as "financial toxicity." To measure this toxicity precisely, the Comprehensive Score for Financial Toxicity (COST) was developed, and it has become one of today's leading tools for assessing financial toxicity.

COST is a patient-reported outcome measure comprising 11 items that assess financial toxicity across multiple dimensions, from finances and resources to emotional well-being. Patients rate each item on a 0-4 scale, and the ratings are combined into a total score that quantifies the degree of financial toxicity. Scores range from 0 to 44, with higher scores indicating lower financial toxicity.

This science-based approach not only helps patients and healthcare providers better understand the economic burden of treatment, but can also be applied to evaluate the outcomes of different treatment strategies. PATIENTSFORCE has fully integrated the COST framework and launched a free online financial toxicity calculator that cancer patients and caregivers can use to assess themselves. It also opens up deeper research and application possibilities for PAP/PSP (Patient Support Program) initiatives.

With COST and the financial toxicity calculator, we can not only quantify a patient's financial toxicity but also assess the economic impact of treatment more precisely, design more targeted support programs, and work to ease the financial burden patients carry through treatment. This is more than a number—it is an effort to give patients and healthcare providers truly valuable information. Through this work, we hope every patient can navigate the economic challenges of treatment with greater confidence.

Sean Chang, General Manager, Media-WIND Health Group (MWHG)