The Impact of Financial Toxicity on Quality of Life in Hidradenitis Suppurativa Patients: A Single-Center Cross-Sectional Survey Study

Summary: Objectives: Hidradenitis suppurativa (HS) poses significant challenges for patients and the healthcare system due to its chronic nature, high treatment costs, and frequent use of costly healthcare services (e.g., ED, inpatient care). This study aims to assess whether financial toxicity independently predicts quality of life in HS patients and to identify patient and disease factors that predict financial toxicity. Methods: The COST-FACIT and DLQI surveys were administered to 30 patients at the UVA HS specialty clinic. Pearson’s correlation coefficient was used to calculate the relationship between COST-FACIT and DLQI scores. A multiple linear regression model was employed to predict COST-FACT scores based on demographic and clinical factors. Results: Of the 30 patients, the majority were women (66.7%) with a mean age of 37. Most were Hurley stage 3 (46.7%) with a history of surgeries (76.7%) and pilonidal sinus (63.3%). The mean COST-FACIT score was 17.5 ± 10.4, indicating grade 1 financial toxicity. Surprisingly, better financial wellbeing was strongly correlated with worse quality of life (r=0.983; p<0.01). Predictors such as age, sex, BMI, and comorbidities were unrelated to financial toxicity; the best-fitting predictors, though not statistically significant, were obesity and disease duration. Conclusions: Healthcare providers should not assume that patients with severe disease impact are necessarily experiencing greater financial toxicity. Patients experiencing greater impact from HS may be more likely to seek out or qualify for financial support programs and obtain healthcare resources. The relationship between the two factors might be more complex than expected, warranting further investigation with larger sample sizes.