Eid D, Jabbour J, Moujaes E, Kourie HR, Safieddine M, Kattan J. Impact of the economic crisis and drug shortage on Lebanese cancer patients’ care. World J Clin Oncol 2024; 15(5): 644-652 [PMID: 38835845 DOI: 10.5306/wjco.v15.i5.644]
Corresponding Author of This Article
Dollen Eid, MD, Doctor, Department of Hematology and Oncology, Saint Joseph University, Faculty of Medicine, Damascus Road, Mar Mikhaël, Beirut 0000, Lebanon. dolleneid@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. May 24, 2024; 15(5): 644-652 Published online May 24, 2024. doi: 10.5306/wjco.v15.i5.644
Impact of the economic crisis and drug shortage on Lebanese cancer patients’ care
Dollen Eid, Jad Jabbour, Elissar Moujaes, Hampig Raphael Kourie, Maissa Safieddine, Joseph Kattan
Dollen Eid, Jad Jabbour, Department of Hematology and Oncology, Saint Joseph University, Faculty of Medicine, Mar Mikhaël, Beirut 0000, Lebanon
Elissar Moujaes, Department of Hematology and Oncology, Institut Gustave Roussy, Villejuif 94800, France
Hampig Raphael Kourie, Joseph Kattan, Department of Hematology and Oncology, Hôtel-Dieu de France University Hospital, Beirut 0000, Lebanon
Maissa Safieddine, Clinical Research Center, Saint Joseph University, Beirut 0000, Lebanon
Co-first authors: Dollen Eid and Jad Jabbour.
Author contributions: Eid D and Jabbour J contributed equally to the data collection and analysis and writing of the manuscript; Moujaes E supervised the research study and contributed to the final version of the manuscript; Kourie HR, Eid D, and Jabbour J conceived the idea of the research study; Safieddine M analyzed the data and revised the statistics; Kattan J designed and supervised the research study.
Institutional review board statement: The Institutional Review Board of Hôtel Dieu de France University Hospital provided approval for this study (IRB No. CEHDF 1903).
Informed consent statement: Patients received an explanation of the study objectives, consented to fill out the questionnaire, and were assisted by one of the interns during its completion on-site.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study were collected anonymously within a Google Sheet Form that can only be shared between the team members working on this study. They are available from the corresponding author (Dollen Eid, dolleneid@gmail.com) upon reasonable request.
STROBE statement: The authors have read the STROBE Statement–checklist of items, and the manuscript was prepared and revised according to the STROBE Statement–checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dollen Eid, MD, Doctor, Department of Hematology and Oncology, Saint Joseph University, Faculty of Medicine, Damascus Road, Mar Mikhaël, Beirut 0000, Lebanon. dolleneid@gmail.com
Received: January 6, 2024 Peer-review started: January 6, 2024 First decision: January 17, 2024 Revised: February 12, 2024 Accepted: March 27, 2024 Article in press: March 27, 2024 Published online: May 24, 2024 Processing time: 135 Days and 19 Hours
Abstract
BACKGROUND
As a consequence of the economic crisis, the sociopolitical instability and the advent of the coronavirus disease-19 pandemic, nested challenges faced the Lebanese healthcare system. These have resulted in critical shortages of essential resources, including medications vital for oncologic patients.
AIM
To assess the ramifications of the ongoing economic crisis on oncology patient care focusing on our outpatient oncology department.
METHODS
A questionnaire was distributed during the month of February 2022 to oncology patients in Hôtel Dieu de France University Hospital in Beirut during their outpatient therapy. The primary objective was to assess the far-reaching impact of the economic crisis on patient care and the resulting psychological implications.
RESULTS
Among 182 interviewed patients, 31.87% experienced treatment interruption mainly due to acute drug shortages. Despite 87.91% of the patients benefiting from third-party coverage, 69.60% had to self-pay for their medications leading to 69.78% of patients perceiving that healthcare was more difficult to access after 2020. Psychologically, one-third of the patients exhibited symptoms of anxiety and/or depression, with 7 patients reporting suicidal ideations. Notably, 37.93% of patients who interrupted cancer treatment reported a history of comorbidities, and 89.66% who altered their treatment cited financial difficulties.
CONCLUSION
Lebanese cancer patients face complex challenges spanning economic, healthcare, and psychological realms. Income inequalities exacerbated by the economic crisis hindered healthcare access.
Core Tip: The Lebanese healthcare system, strained by economic crisis, sociopolitical unrest, and the coronavirus disease 2019 pandemic, faces critical shortages, impacting vital oncology medications. In February 2022, a questionnaire was administered to 182 oncologic patients at Hôtel Dieu de France University Hospital, Beirut during outpatient therapy. Results revealed that 31.87% experienced treatment interruptions due to acute drug scarcities. Despite 87.91% having third-party coverage, 69.60% self-funded medications, leading to 69.78% perceiving limited healthcare access post-2020. Psychologically, one-third exhibited anxiety/depression symptoms, and 7 patients reported suicidal thoughts. Most patients altered their treatment plan, citing financial strains.
