Economic Burden of Cancer Treatment in a Region in South India: A Cross Sectional Analytical Study

Asian Pac J Cancer Prev. 2021 Dec 1;22(12):3755-3762. doi: 10.31557/APJCP.2021.22.12.3755.

Abstract

Introduction: The rising cost of cancer diagnosis and treatment has imposed a huge financial burden on the affected households. Understanding the nature of this burden will help us to formulate plans to avoid financial distress among the same.

Objective: The study aims to estimate the Out of Pocket Expenditure (OOPE) for the management of selected solid cancers among the Out-Patient Department (OPD) of Regional Cancer Centre in South India and to determine the proportion of families experiencing Catastrophic Health Expenditure (CHE) due to the same.

Methods: A hospital based cross sectional analytical study was undertaken in the authors' institute in South India. 474 solid cancer patients were interviewed in OPD of Radiation Oncology by a trained data collector. Sociodemographic variables, costs incurred under various headings and expenditure details of participants were obtained. Direct Medical and Direct Non-Medical costs were calculated, and its total was used as the OOPE. Costs were presented as mean with its standard error. Incidence of CHE was calculated using the 40% threshold on the Capacity to pay and was expressed as proportions with 95% confidence interval. Appropriate statistical tests were used to look for statistically significant differences in the study groups.

Results: The average OOP expenditure incurred by a cancer patient was INR 35,817 (USD 523.6) for male and INR 20,496 (USD 299.6) for female. Males had a significantly higher OOPE than females. The prevalence of catastrophic health expenditure (CHE) was 61.6% at the 40% CTP threshold. Patients who used insurance schemes had higher prevalence of CHE than those who did not use insurance schemes (65.5% vs 60.7%, p value 0.351).

Conclusion: Cancer care provided through public institutions had a low direct medical cost, but the indirect cost seemed to be extremely high. Public based financial assistance is the need of the hour to help the cancer affected families.

Keywords: Cancer burden; Economic burden; Out of pocket expenditure; catastrophic health expenditure.

MeSH terms

  • Adult
  • Aged
  • Catastrophic Illness / economics*
  • Cost of Illness*
  • Cross-Sectional Studies
  • Female
  • Financial Stress / epidemiology*
  • Financial Stress / etiology
  • Health Expenditures / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / economics*
  • Socioeconomic Factors