Background: To assess the treatment pattern and expenditure incurred by cancer patients undergoing treatment at government tertiary hospitals in India. Materials and Methods: A cross-sectional study of 508 cancer patients randomly selected from tertiary cancer hospitals funded by central/state governments located in major cities of five states in India, namely Kerala, Maharashtra, Rajasthan, West Bengal and Mizoram, during March -May 2011 was conducted. Information related to direct costs, indirect costs and opportunity costs incurred on investigations and treatment, major source of payment and difficulties faced by patients during the course of treatment was collected. Results: About 45% of the patients used private health facilities as the first point of contact for cancer related diseases as against 32% in public hospitals. About 47% sought private health facilities for cancer investigations, 21% at district/sub-district hospitals, and about 4% contacted primary health care facilities. A majority of the patients (76%) faced financial problems while undergoing treatment. Conclusions: The results highlight the importance of involving the primary health care system in the cancer prevention activities.

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Rashtriya Swasthya Bima Yojana aims to improve access to quality health care and relieve the burden of health care costs of the poor population. This article, based on interviews conducted with different stakeholders of the scheme during October–December 2010, looks at the implementation of the scheme in Delhi. A large proportion of the beneficiaries were unaware about the features and benefits of the scheme. A significant proportion of the families availing benefits had incurred the out-of-pocket expenses. The coverage of population was very low. The empanelled hospitals/nursing homes were hesitant in admitting patients with chronic ailments requiring continuous treatment at the hospital. Low package rates and delay in settlement of claims were reported as the major issues by the empanelled hospitals.

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