Cost Drivers and Financial Burden for Cancer-Affected Families in China: A Systematic Review

Abstract

This systematic review examined cancer care costs, the financial burden for patients, and their economic coping strategies in mainland China. We included 38 quantitative studies that reported out-of-pocket payment for cancer care and patients’ coping strategies in English or Chinese (PROSPERO: CRD42021273989). We searched PubMed, Embase, Ovid, Web of Science, Cochrane, CNKI, and Wanfang Data from 1 January 2009 to 10 August 2022. We referred to the standards for reporting observational studies to assess the methodological quality and transparent reporting of the included studies and reported the costs narratively. Annual mean medical costs (including inpatient and outpatient costs and fees for self-purchasing drugs) ranged from USD 7421 to USD 10,297 per patient. One study investigated medical costs for 5 years and indicated that inpatient costs accounted for 51.6% of the total medical costs, followed by self-purchasing drugs (43.9%). Annual medical costs as a percentage of annual household income ranged from 36.0% to 63.1% with a metaproportion of 51.0%. The common coping strategies included borrowing money and reduction of household expenses and expenses from basic health services. Costs of inpatient care and self-purchasing drugs are major drivers of medical costs for cancer care, and many affected households shoulder a very heavy financial burden.

Knowledge, attitudes, and practices regarding cancer screening and primary prevention among ethnic minorities in mainland China: A literature review

“…Potentially additional economic burdens might explain why some ethnic minorities are not willing to undergo cancer screening even when the cost of screening is waived; these may include the costs of transportation and of follow-up examinations and treatment after cancer detection. 45 Therefore, additional financial support, such as medical insurance for cancer treatment, is needed to relieve ethnic minorities’ concerns about the uptake of cancer screening.…”

Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study

“…While advances in cancer screening and treatment have improved survival times, 1 the rising costs of anti-cancer therapies have raised concerns about access to care, the quality of care, and the overall well-being in diverse healthcare systems such as those in China. 2 In China, despite a publicly funded healthcare system with almost universal access to medical insurance, residents with cancer face significant health-related financial challenges. Although more than 95% of Chinese residents are covered by Urban Employee Basic Medical Insurance (UEBMI) or Urban and Rural Resident Basic Medical Insurance (URRBMI) plans, 3 a significant out-of-pocket (OOP) health expenditure burden remains.…”