Cost of treatment for head and neck cancer in India

Abstract

There are no published data on the cost of cancer treatment for guiding reimbursement decisions in India. The present study was designed to estimate the cost of treating head and neck cancer (HNC) with the aim of determining package rates. The present study was undertaken in the Departments of Radiotherapy and Otolaryngology of a large tertiary care hospital in North India. Economic health system costs incurred were assessed using a bottom-up methodology. Data on all resources–capital or recurrent, incurred on the delivery of HNC treatment were collected from April 2014 to March 2015. Following the cost-of-illness approach, patients were interviewed to elicit out-of-pocket (OOP) expenditure. A total of INR 40,993,017 (USD 0.67 million) was spent on radiotherapy care for treating HNC during 1 year. Salaries constituted the major component (42.6%) of this cost, followed by equipment/furniture (29%), space rent (20.7%), overheads and consumables (7.7%). In addition, INR 47,191 (USD 773) per HNC patient was spent on the surgery. Furthermore, patients spent an average amount ranging from INR 12,575 (USD 206) to INR 65,257 (USD 1069) on the different treatment therapies. In terms of package rates, cobalt radiotherapy alone was the cheapest (INR 38,714, USD 634), while intensity modulated radiotherapy (IMRT) was most expensive (INR 192,914, USD 3161). The estimates from the present study could be used for developing package rates under various publicly financed health insurance schemes as well as for the planning for creation of new cancer centres.

Cost of Treatment for Cervical Cancer in India

“…Thus, it becomes necessary to estimate both the health system cost and OOPE while estimating the total cost of treatment. There is only a single study which comprehensively assessed the cost of head and neck cancer treatment from societal perspective (Chauhan et al, 2018). Other studies were either focussed on health system cost or OOPE (Chatterjee et al 2013;Chauhan et al, 2013;Mahal et al, 2013;Rajpal et al 2018).…”

“…We could find a single study which estimated the total cost of head and neck cancer treatment from a societal perspective (Chauhan et al, 2018). Although, there are few economic analysis of cancer treatment, most of these have only assessed OOPE only (Mahal et al, 2013;Mohanti et al, 2011;Mondal et al, 2014;Rajpal et al, 2018).…”

“…The recruited patients were interviewed based on a pre-tested semi-structured interview schedule, adapted from previous studies done in the similar settings (Chauhan et al, 2018;Prinja et al, 2019;Prinja et al, 2018;Prinja et al, 2017b;Prinja et al, 2016). It included information on socio-demographic characteristics, duration of treatment, consumption expenditure, insurance status, OOPE incurred on diagnosis/treatment and coping mechanisms for dealing with the same.…”

Estimating the Unit Costs of Healthcare Service Delivery in India: Addressing Information Gaps for Price Setting and Health Technology Assessment

“…Insurance claims data from 22 different government-funded schemes have also been collated into a single database; however, these estimates reflect prices agreed by tender and do not represent the cost of production [7,9]. More recently, the availability of production cost data for the public sector has begun to grow with individual costing studies that have been carried out to explore the cost-effectiveness of different technologies as well as a series of primary costing studies [10][11][12][13][14][15][16][17][18][19]. However, the paucity of cost information remains a significant fact within the Indian health system [7,20].…”

“…At the global level, the World Health Organization (WHO) has used such an approach to predict country specific unit costs [29,30]. In India, efforts, including those by the present authors, towards estimating costs and understanding the cost structures of healthcare facilities have begun [11][12][13][14][15][16][17][18]21]. While these first studies have provided cost data for different levels of the health system, they have been undertaken in a limited number of facilities and states.…”