Modeling Financial Insolvency and Income Loss Insurance in Head and Neck Cancer

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Abstract
Background: Head and neck cancer (HNC) carries high morbidity, and its treatment can be functionally devastating, impacting a patient’s ability to work. While most patients have medical insurance benefits, studies on the impact of HNC on overall household finances have been limited. Objectives: This study explored the effect of HNC treatment on household finances and the feasibility of catastrophic income loss insurance. Methods: This cross-sectional study was based on a population-level survey of American adults. Participants, aged 35 to 64 years, were respondents to the US Federal Reserve 2023 Survey on Household Economics and Decisionmaking (SHED). Results: With total income loss, 16% of simulated HNC patients were insolvent after 3 months, rising to 49% at 6 months. With a 50% loss in income, 3% of patients were insolvent at 3 months, increasing to 5% at 6 months. If savings were liquid, 0.5% of patients were insolvent at 3 months, rising to 1.3% at 6 months. Discussion: Our findings underscore the substantial financial vulnerability faced by patients undergoing treatment for HNC. Even in a simulated model based on national economic data, nearly half of patients experiencing total income loss were insolvent by 6 months. Given the intensive and prolonged nature of HNC treatment, these financial challenges may compound physical and psychosocial stressors, affecting overall recovery and quality of life. Conclusion: The model suggested a need for more substantial income loss protection programs. Financial hardship applies to other cancer types and merits further study into the household financial impact of HNC and other cancers.