# Financial Toxicity in Chronic Obstructive Pulmonary Disease

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2024 · $97,364

## Abstract

PROJECT SUMMARY/ABSTRACT
Chronic obstructive pulmonary disease (COPD) is a slowly progressive disease that affects more than 13
million Americans and results in a long period of disability and reduced health related quality of life (HRQoL).
Individuals with COPD are at high risk of financial burden from illness due to costly inhaled bronchodilators,
unplanned ED visits and hospitalizations for acute exacerbations, as well as income loss due to disability.
Financial toxicity, a term that describes the objective financial burden and subjective financial distress resulting
from treatment for illness, has not been studied in COPD but is prevalent in other chronic medical conditions
and has been associated with worse health outcomes. In contrast to absolute cost, financial toxicity takes into
account the proportion of cost to an individual’s or family’s income and its psychological and behavioral impact.
While cost has not been directly associated with worse outcomes in COPD, limited observational studies
relying on self-reported adherence suggest that cost of treatment may contribute to suboptimal medication
adherence. Poor adherence, in turn, is associated with worse outcomes including increased risk of
exacerbations and mortality. Due to the high risk for financial burden in COPD, understanding the association
between financial toxicity, a potentially modifiable determinant, and health outcomes is key to informing future
interventions.
The main objective of this proposal is to describe the impact of financial toxicity on health outcomes in
individuals with COPD. We hypothesize that financial toxicity from treatment of COPD is associated with
increased disability, decreased health related quality of life (HRQoL), and decreased medication adherence
over time. We will use both quantitative and qualitative methods to comprehensively evaluate the role of
financial toxicity in individuals with COPD. Using the Medical Expenditure Panel Survey (MEPS), a large
nationally-representative longitudinal panel, we will assess the association between material financial toxicity
resulting from treatment of COPD with disability and health related quality of life (Specific Aim 1) and
medication adherence (Specific Aim 2). To better understand the impact of financial toxicity on patient
outcomes, we will conduct qualitative semi-structured interviews with individuals who report financial burden
related to treatment for COPD (Specific Aim 3). Taken together, the work from these complementary aims has
the potential to identify areas for a future intervention to mitigate the adverse effects of financial toxicity in this
population, which would serve as the basis for the applicant’s future career development award. This proposal
will also provide the applicant with the skills needed to pursue an independent career as a health services
researcher studying COPD.

## Key facts

- **NIH application ID:** 10998008
- **Project number:** 1F32HL176086-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Sonal Mallya
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $97,364
- **Award type:** 1
- **Project period:** 2024-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10998008

## Citation

> US National Institutes of Health, RePORTER application 10998008, Financial Toxicity in Chronic Obstructive Pulmonary Disease (1F32HL176086-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10998008. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*