Development and Validation of a Multilateral Index to Determine Economic Status in Developing Countries: The Patient Financial Evaluation Tool (PFET)

This is the original study that developed and tested the Patient Financial Evaluation Tool (PFET), using data from 117 cancer patients across China, India, Thailand, and Malaysia to see whether a combined measure of income, spending, and assets could accurately predict a patient’s real ability to pay for medication. The tool proved highly reliable and closely matched patients’ actual purchasing behavior, establishing it as a credible foundation for future access programs.

• The tool showed strong internal reliability, meaning its different financial questions consistently pointed to the same underlying picture of a patient’s financial status.
• When compared against what patients actually spent on medication in real life, the tool’s predictions matched exactly for more than half of patients and were very close for most of the rest.
• This established a repeatable method for building the tool country by country, which later studies used to test and refine it in new markets.
• As the founding study behind PFET, this work provides the original evidence that a multi-factor financial assessment can reliably guide fairer, tiered pricing models that expand access to expensive medications in lower-income countries.