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Background <p>Young cancer patients are often at risk of losing their fertility due to the disease itself or its treatment. Fertility preservation measures (FPM) can be costly and financially distressing. Since July 2021, the implementation of the cryopreservation guideline (CG) has covered many FPMs under statutory health insurance. This study examines whether this change has provided relief for patients and how it influences the decision to undergo FPM.</p> Methods <p>An cross-sectional study interviewed oncology patients in Germany in 2024. Two items are used to measure subjective financial distress (SFD) and its influence on the decision for FPM. A total of 312 cases satisfied the selection criteria (decision in favor of or against FPM; hypothetically eligible). T-tests were used to test for group differences (before vs. after the introduction of the CG; gender-specific differences; statutory vs. private health insurance).</p> Results <p>Following the implementation of the CG, the proportion of patients who did not have to bear the costs of FPM themselves doubled (20.5% before vs. 41.7% after). The SFD (t(188,78) = 3,8, p = 00,001, d = 0,52) and the negative influence on treatment decisions decreased significantly (t(196,08) = 5,17, p = 00,001, d = 0,72) among patients with statutory health insurance. Prior to the implementation, female subjects reported a stronger influence of costs on their decision than their male counterparts (t(37,7) = 6,23, p = 0,001, d = 0,70). This discrepancy has diminished since the implementation of the guideline.</p> Conclusion <p>The CG has reduced the SFD for FPM. Despite this improvement, many patients continue to bear costs, indicating existing – partly intentional, partly undesirable – gaps in cost coverage and its practical implementation.</p>

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Finanzielle Belastung durch fertilitätserhaltende Maßnahmen – entlastet die Kryo-Richtlinie onkologische Patient:innen?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月18日

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  • Lisa Strampfer,
  • Nils Ellebrecht,
  • Annette Hasenburg,
  • Joachim Weis

摘要

Background

Young cancer patients are often at risk of losing their fertility due to the disease itself or its treatment. Fertility preservation measures (FPM) can be costly and financially distressing. Since July 2021, the implementation of the cryopreservation guideline (CG) has covered many FPMs under statutory health insurance. This study examines whether this change has provided relief for patients and how it influences the decision to undergo FPM.

Methods

An cross-sectional study interviewed oncology patients in Germany in 2024. Two items are used to measure subjective financial distress (SFD) and its influence on the decision for FPM. A total of 312 cases satisfied the selection criteria (decision in favor of or against FPM; hypothetically eligible). T-tests were used to test for group differences (before vs. after the introduction of the CG; gender-specific differences; statutory vs. private health insurance).

Results

Following the implementation of the CG, the proportion of patients who did not have to bear the costs of FPM themselves doubled (20.5% before vs. 41.7% after). The SFD (t(188,78) = 3,8, p = 00,001, d = 0,52) and the negative influence on treatment decisions decreased significantly (t(196,08) = 5,17, p = 00,001, d = 0,72) among patients with statutory health insurance. Prior to the implementation, female subjects reported a stronger influence of costs on their decision than their male counterparts (t(37,7) = 6,23, p = 0,001, d = 0,70). This discrepancy has diminished since the implementation of the guideline.

Conclusion

The CG has reduced the SFD for FPM. Despite this improvement, many patients continue to bear costs, indicating existing – partly intentional, partly undesirable – gaps in cost coverage and its practical implementation.