30 June 2025

Cancer doesn’t just affect health; it often has a major impact on people’s financial and social lives as well. A landmark study led by the Netherlands Cancer Institute, funded by the European Fair Pricing Network, reveals that cancer patients across Europe lose income, face additional out-of-pocket costs, and even avoid medical care due to financial stress following diagnosis. Adolescents and young adults are especially vulnerable.

The results, based on a survey of more than 2,500 cancer patients across 25 European countries, expose stark disparities both within and between EU member states. The findings underscore the urgent need for stronger, EU-wide policy measures to protect all patients, regardless of where they live.

The study, published in ESMO Open with a separate analysis of a subgroup of adolescents and young adults published in the International Journal of Cancer, is the first of its kind to compare the financial and socioeconomic impacts of cancer across Europe.

Key findings show that:

• 56% of cancer patients reported a loss of income due to their diagnosis. This was highest in Cyprus (66%) and Finland (63%), and lowest in the Netherlands (51%) and Spain (52%).
• Nearly a third of patients (28%) saw their income drop by 200 to 800 Euros per month. In countries like Switzerland, Denmark, and Cyprus, some patients lost more than 1,200 Euros per month.
• 86% reported additional treatment-related expenses, including travel costs and non-reimbursed medications. Patients in Bulgaria, Finland, and the Netherlands were most affected by high travel costs. To cope with these expenses, many patients tried to increase their income or cut other expenses – particularly in Bulgaria, Cyprus, Finland, and Belgium.
• 16% of patients said that they had to postpone or avoid care (including medications, doctor visits, or surgery) altogether due to financial concerns. This trend was registered most in Bulgaria (38%), Belgium (23%), Germany (22%), and France (21%).

Additionally, more than a third of patients experienced a change to their employment status, with fewer people working or studying, and more retiring early, becoming unemployed, or going on disability. These changes were most noticeable in Spain, Belgium, and Cyprus. The Netherlands, Bulgaria, and Belgium experienced the highest increase in retirement.

Importantly, the type of cancer or the specific treatment patients received had little impact on their financial situation, underscoring the systemic nature of these challenges. The results showed that people who were divorced, self-employed, had lower household incomes, or had children at the time of diagnosis were more likely to experience financial hardship.

The findings show adolescents and young adults aged 18 to 39 are particularly vulnerable. Out of a subgroup of 577 young people, nearly 80% reported financial difficulties, 65% experienced income loss, and many considered the available support inadequate. Healthcare providers also noted that support measures are often ineffective (22%) or only partially effective (63%).

“The socioeconomic consequences of a cancer diagnosis proved to be far more serious than we expected, even in countries with well-established health system coverage and social benefit systems. Our study warns us that it is a misconception that European social systems protect all patients from the financial consequences of a cancer diagnosis. Especially adolescents and young adult cancer patients are affected, and guidance and services for these patients should be improved”, says Professor Wim van Harten from the Netherlands Cancer Institute, who co-led the study.

The study also highlights how differences in national labour markets, social support systems, and healthcare financing models play a significant role in determining the extent of the socioeconomic impact experienced by patients with cancer. In addition to the national employment and social security landscape, the socioeconomic impact of cancer is also affected by specific reimbursement policies and overall healthcare systems.

“No one should be financially punished for having cancer. This landmark study shows that a significant number of cancer patients in Europe lose income, face extra costs, and even avoid medical care, while differences between countries deepen existing inequalities”, says Toma Mikalauskaitė, Policy Lead at the Association of European Cancer Leagues (ECL) on behalf of the European Fair Pricing Network.

“EU and national policymakers must take all necessary steps to guarantee social, labour, and financial protections for all cancer patients. This includes EU-wide standards to uphold the right to be forgotten in financial services and to support survivors wishing to return to work.”

Notes:

• The study, titled ‘Financial Toxicity and Socioeconomic Impact of Cancer in Europe’, was initiated and funded by the European Fair Pricing Network (EFPN) and the Organisation of European Cancer Institutes (OECI).
• The results are based on a survey of more than 2,500 cancer patients across 25 European countries. Data for the study was collected between September 2021 and September 2022 via an online patient survey available in 16 languages across 25 countries:

	N	%
Spain	520	20.7
The Netherlands	413	16.5
France	241	9.6
Germany	208	8.3
Bulgaria	201	8
Norway	196	7.8
Cyprus	192	7.7
Denmark	176	7
Finland	127	5.1
Belgium	96	3.8
Switzerland	47	1.9
Czech Republic	25	1
Greece	22	0.9
UK	15	0.6
Lithuania	8	0.3
Croatia	7	0.3
Other countries (n = 6)	6	0.2
Romania	3	0.1
Portugal	2	0.1
Sweden	2	0.1

For further information, please contact Ivonne Leenen, Communications Officer at the Association of European Cancer Leagues (ECL): ivonne@cancer.eu  

The European Fair Pricing Network (EFPN) aims to achieve fair prices for cancer medicines and, more broadly, work towards a pharmaceutical market which produces accessible and truly innovative medicines for patients. The network represents the Association of European Cancer Leagues (ECL), the Cyprus Association of Cancer Patients and Friends, the Dutch Cancer Society, the Netherlands Cancer Institute, the Nordic Cancer Union, the Norwegian Cancer Society, the Organisation of European Cancer Institutes (OECI), Stand Up To Cancer Flanders, and the Swiss Cancer League.

The Association of European Cancer Leagues (ECL) is a non-profit, pan-European umbrella organisation of national and regional cancer societies. ECL provides an exclusive platform for members to collaborate with their international peers, primarily in the areas of cancer prevention, access to medicines and patient support, and creates opportunities to advocate for these issues at the EU level. Transparency registry no: 19265592757-25