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NEW DELHI: A cancer patient spends close to Rs 3.3 lakh annually out-of-pocket on her or his treatment regardless of their status vis-à-vis insurance coveragea study carried out among 12,148 cancer patients seeking treatment at seven top medical institutions in the country including AIIMS Delhi, PGI Chandigarh and Tata Memorial Centre Mumbai has revealed.
The study, which has been published in the journal ‘Frontiers in Public Health (FPH)’, shows that an average cancer patient spends Rs 8,053 per outpatient consultation out-of-pocket. The mean direct Out-Of-Pocket Expenditure (OOPE) per episode of hospitalisation is estimated as Rs 39,085.
But because of the repetitive nature of outpatient care, the study suggests, outpatient treatment is more likely to cause catastrophic health expenditure (CHE) and impoverishment (80% and 67%, respectively) than hospitalisation (30% and 17%, respectively).
Approximately 60% of the patients seeking outpatient treatment and 62.8% hospitalised patients were found to be covered under some health insurance schemes in the multicenter study.
Outpatient treatment includes chemotherapy as well as diagnostics for routine monitoring and supportive care. The researchers point out in the study that the majority of the publicly financed health insurance schemes include only inpatient care in its health benefits package, leaving outpatient care out of the ambit. Even for the inpatient care which is covered, the financial protection starts to kick in once the diagnosis is established, which implies that the initial diagnostics and staging in case of probable cancer cases is paid out-of-pocket by the patients, they add.
“The health benefits package of Ayushman Bharat PM-JAY should prioritise the expansion of cancer packages, by including the cost-effective treatments which may be delivered in outpatient care. Secondly, the digital payment systems should be used to finance the cost of diagnostic services available for staging of cancer patients before the treatment begins,” the study, led by Dr Shankar Prija suggests.
According to the FPH study, diagnostic tests accounted for 36% of all OOPE for outpatient treatment. In case of hospitalisation, a maximum 45% of the OOPE was incurred in buying medicines.



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