Cost of Treatment for Cervical Cancer in India

Singh, Maninder Pal; Chauhan, Akashdeep Singh; Rai, Bhavana; Ghoshal, Sushmita; Prinja, Shankar

doi:10.31557/apjcp.2020.21.9.2639

Cited by 35 publications

(44 citation statements)

References 25 publications

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“…This could partly be explained based on the fact that the previous study took a health system perspective and did not account for what the patients spent. It is well recognized that the patients spend a significant amount as out-of-pocket expenditure [ 23 , 30 – 32 ]. In our study, we also valued the resources for which the patients had paid for.…”

Section: Discussionmentioning

confidence: 99%

“…The standard principles of health system costing were used for the CHSI study [ 15 , 21 , 22 ], which was further guided by the previous studies in similar settings [ 15 , 17 , 23 – 25 ]. The cost of healthcare services was calculated following the concept of economic costing and a mixed (top-down and bottom-up) micro-costing methodology.…”

Section: Methodsmentioning

confidence: 99%

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Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes

Singh

Prinja

Rajsekar

et al. 2022

PharmacoEconomics Open

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Background In low- and middle-income countries (LMICs), provisioning for surgical care is a public health priority. Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY) is India’s largest national insurance scheme providing free surgical and medical care. In this paper, we present the costs of surgical health benefit packages (HBPs) for secondary care in public district hospitals. Methods The costs were estimated using mixed (top-down and bottom-up) micro-costing methods. In phase II of the Costing of Health Services in India (CHSI) study, data were collected from a sample of 27 district hospitals from nine states of India. The district hospitals were selected using stratified random sampling based on the district’s composite development score. We estimated unit costs for individual services—outpatient (OP) visit, per bed-day in inpatient (IP) and intensive care unit (ICU) stays, and surgical procedures. Together, this was used to estimate the cost of 250 AB PM-JAY HBPs. Results At the current level of utilization, the mean cost per OP consultation varied from US$4.10 to US$2.60 among different surgical specialities. The mean unit cost per IP bed-day ranged from US$13.40 to US$35.60. For the ICU, the mean unit cost per bed-day was US$74. Further, the unit cost of HBPs varied from US$564 for bone tumour excision to US$49 for lid tear repair. Conclusions Data on the cost of delivering surgical care at the level of district hospitals is of critical value for evidence-based policymaking, price-setting for surgical care and planning to strengthen the availability of high quality and cost-effective surgical care in district hospitals. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-022-00342-6.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes

Singh

Prinja

Rajsekar

et al. 2022

PharmacoEconomics Open

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“…Caregivers in that setting often sold their possessions or take on additional responsibilities in order to make enough money to pay for the medication (Walker 2011) The disease has the potential to induce or worsen poverty. Studies from the west have shown caregivers sometimes even declare bankruptcy as a result of caregiving-related costs (Singh, Chauhan et al 2020). In this study, we saw one caregiver who had defaulted on loan repayments and lived in fear of their property being auctioned, and other caregivers selling land and livestock to raise funds necessary for treatment and care.…”

Section: Conclusion and Recommendationsmentioning

confidence: 98%

Financial Toxicity Related to Advanced Cancer Patients’ Care: Case study of Selected Households of Kiambu County, Kenya

2022

JHMN

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The aim of this study is to investigate family caregiver's experiences on household financial burden related to cancer treatment/care following referral to a palliative care unit in Kenya. Methodology: Case study approach was used to collect data from caregivers of advanced cancer patients following referral to a palliative care unit at Kijabe Mission Hospital in Kenya. This approach is best suited to gain insight into economic implication of the rising cost of cancer treatment which has put a considerable financial strain on affected families, leading to adverse outcomes of caring for patients with advanced cancer. Semi-structured in-depth interviews, documentary data and field notes, observations were used to collect information relating to financial and economic impact of the careburden experiences from theoretical sample of 12 caregivers. This approach enabled an in-depth, multifaceted explorations of complex issues related to in their real-world contexts. The case study method was particularly chosen because of its richness to gain an in-depth understanding of an issue, event, or phenomenon of interest in its natural real-life context. A sociotechnical coding matrix was used to analyze qualitative data thematically, along with additional themes that emerged from the data. All ethical considerations were observed accordingly. Findings -Four (4) male and eight (8) female caregivers interviewed were between 18 to 67 years. The study reports families facing enormous financial strain and difficulties treating their patient with advanced cancer patient. Treating patient with advanced cancer is reported to drain resources threatening to bring vicious cycle of poverty and financial stability. Family members get frustrated at their inability to meet growing demands related to care, treatment and management of their patient in advanced stage of cancer. Financial concerns, catastrophic health expenditure (CHE) and distress financing (DF as part of devastating effects of cancer, limited health insurance coverage and gaps in financing are among the key concerns identified. Unique contributions to theory, practice and policy: This study builds evidence towards social and conomic consequences of treating advanced cancer diseases that affect household families and impact on life of patients with advanced cares. Hence, seeks to shape how multidisciplinary cancer care teams' practices to become more aware of the costs of their clinical decisions. Findings of this study also form basis of review of already existing policies related to insurance coverage provided by state agency to tailor it to chronic diseases. Further research is required to mitigate financial toxicity and additional financial safety nets

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“…The unit health system cost of specific services was derived from the previously undertaken costing studies from India (Table 2). 21,22 Where published cost data were not available, estimates from reimbursement rates of Cost-Effectiveness Analysis of Bevacizumab central government health scheme was used. 23,24 Price of drugs was assessed from procurement prices of Rajasthan Medical Services Corporation.…”

Section: Costs Of Treatmentmentioning

confidence: 99%

“…org/10.1200/GO. 21. 00355 (17 months v 13.3 months) in patients with advanced and metastatic cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Cost Effectiveness of Bevacizumab Plus Chemotherapy for the Treatment of Advanced and Metastatic Cervical Cancer in India—A Model-Based Economic Analysis

Gupta

Nehra

Chauhan

et al. 2022

JCO Global Oncology

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PURPOSE Patients with advanced and metastatic cervical cancer have a poor prognosis with a 1-year survival rate of 10%-15%. Recently, an antiangiogenic humanized monoclonal antibody bevacizumab has shown to improve the survival of these patients. This study was designed to assess the cost effectiveness of incorporating bevacizumab with standard chemotherapy for the treatment of patients with advanced and metastatic cervical cancer in India. METHODS Using a disaggregated societal perspective and lifetime horizon, a Markov model was developed for estimating the costs and health outcomes in a hypothetical cohort of 1,000 patients with advanced and metastatic cervical cancer treated with either standard chemotherapy alone or in combination with bevacizumab. Effectiveness data for each of the treatment regimen were assessed using estimates from Gynecologic Oncology Group 240 trial. Data on disease-specific mortality in metastatic cervical cancer, health system cost, and out-of-pocket expenditure were derived from Indian literature. Multivariable probabilistic sensitivity analysis was undertaken to account for parameter uncertainty. RESULTS Over the lifetime of one patient with advanced and metastatic cervical cancer, bevacizumab along with standard chemotherapy results in a gain of 0.275 (0.052-0.469) life-years (LY) and 0.129 (0.032-0.218) quality-adjusted life-years (QALY), at an additional cost of $3,816 US dollars (USD; 2,513-5,571) compared with standard chemotherapy alone. This resulted in an incremental cost of $19,080 USD (7,230-52,434) per LY gained and $34,744 USD (15,782-94,914) per QALY gained with the use of bevacizumab plus standard chemotherapy. CONCLUSION Addition of bevacizumab to the standard chemotherapy is not cost effective for the treatment of advanced and metastatic cervical cancer in India at a threshold of 1-time per-capita gross domestic product.

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Cost of Treatment for Cervical Cancer in India

Cited by 35 publications

References 25 publications

Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes

Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes

Financial Toxicity Related to Advanced Cancer Patients’ Care: Case study of Selected Households of Kiambu County, Kenya

Cost Effectiveness of Bevacizumab Plus Chemotherapy for the Treatment of Advanced and Metastatic Cervical Cancer in India—A Model-Based Economic Analysis

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