Financial burden, distress, and toxicity in cardiovascular disease


Slavin SD, Khera R, Zafar SY, Nasir K, Warraich HJ. Financial burden, distress, and toxicity in cardiovascular disease. Am Heart J. 2021;238 :75-84.

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Cardiovascular disease (CVD) is a major source of financial burden and distress, which has 3 main domains: (1) psychological distress; (2) cost-related care non-adherence or medical care deferral, and (3) tradeoffs with basic non-medical needs. We propose 4 ways to reduce financial distress in CVD: (1) policymakers can expand insurance coverage and curtail underinsurance; (2) health systems can limit expenditure on low-benefit, high-cost treatments while developing services for high-risk individuals; (3) physicians can engage in shared-decision-making for high-cost interventions, and (4) community-based initiatives can support patients with system navigation and financial coping. Avenues for research include (1) analysis of how healthcare policies affect financial burden; (2) comparative effectiveness studies examining high and low-cost strategies for CVD management; and (3) studying interventions to reduce financial burden, financial coaching, and community health worker integration.


Slavin, Samuel DKhera, RohanZafar, S YousufNasir, KhurramWarraich, Haider JengReviewAm Heart J. 2021 Aug;238:75-84. doi: 10.1016/j.ahj.2021.04.011. Epub 2021 May 5.