LAUSR

Medical crowdfunding is a rapidly growing phenomenon worldwide and a new means for patients to finance health related expenses. It raises many ethical concerns such as increasing inequities. In the UK, which operates a state-funded universal health care system, the phenomenon is unexpected and hasn't yet been studied. Our study aims at answering basic questions as who is using crowdfunding to fund health-related expenses, for what and why. We have drawn the first 400 medical campaigns amongst 1,000 available on GoFundMe UK website. We used a content analysis method to extract data from narratives on age, sex, health condition and funds' purposes. Among the 400 campaigns, 1/2 requested funds for cancer care for both common and rare cancers, from which 1/3 disclosed a stage 4. A third of the sample sought funds to get treatment abroad, mostly in Germany and the US, for most part cancer therapies such as immunotherapy but also alternative therapies. A quarter of the sample sought support to alleviate financial burden associated with ill-health. Other purposes included getting private care in the UK (19%) and getting medical equipment (18%). Our findings may put forward some gaps within the National Health Service (NHS) and social care such as issues to access therapies or equipment, lack of holistic care and inadequate welfare patient support. However, it does not explain fully the rise of crowdfunding that may also be a counterpart of patients' empowerment. For instance, patients can shift to the private sector, in the UK or abroad, when a treatment is not available within the NHS, such as high cost last-resort treatments for those with poor prognosis. We recommend policy makers to: use medical crowdfunding to inform policy,support patients to make empowered decisions,protect patients from commercial traps. Studying medical crowdfunding allows better understanding of patients’ perceived or actual unmet need for health and social care to inform policy development. This threat to equity should be addressed globally by providing patients with support to be empowered, with universal health coverage and by regulating better private facilities and health tourism.