Financial burden and coping strategies for cancer care in India

Abstract

Problem: Globally 9.3 million deaths occurred due to cancer in 2018. Currently, India has 13.9 lakh cancer cases, which are estimated to increase by 12% by the year 2025. Treatment of cancer inflicts a heavy cost of care and may even impoverish households. Methods: Using the national health survey data for 2017–18, this study estimates the burden of healthcare expenditure due to cancer and coping strategies to pay for treatment. Factors affecting the health care expenditure on cancer are examined using a two-part model. Finding: The monthly values (in 2022 prices) of inpatient and outpatient OOPE on cancer for 2017-18, were found to be ₹6549 and ₹8811 implying that, 37% and 49% of household's monthly consumption expenditure was spent on inpatient and outpatient cancer care, respectively. Households relied on their own income/savings to pay for care and hardship financing was faced even by the higher income quintile patients both for inpatient and outpatient care. The second richest quintile had the greatest odds of borrowing money (0.94[0.54–1.63]).The two-part model shows that the likelihood of incurring expenditure on cancer care is greater at higher age-groups and income quintiles and is lower for females and people seeking care at private facilities. However, the mean expenditure is higher for those using private facilities or belonging to richer quintiles and is lower in urban areas. Conclusion: There is a need for policies to impart financial protection and expand the screening and curative services for cancer, with an assured quality in the public sector to ameliorate the financial burden of cancer care among households in India.

Keywords

• Out of pocket expenditure
• Two-part model
• India
• Cancer