Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

The financial toxicity of cancer care in India

Note4Students

From UPSC perspective, the following things are important :

Mains level: Impact of Cancer;

Why in the News?

The financial strain of cancer is often ignored but can be the most harmful. It not only impacts the patient but also their family and future generations.

What is the extent of financial toxicity faced by cancer patients in India?

  • High Treatment Costs: Cancer treatments, especially advanced options like immunotherapy, can be prohibitively expensive. For instance, a patient with oral cancer may face annual costs of approximately ₹10 lakh, adding to previous expenses that can total ₹25 lakh over several years. This financial strain often forces families to deplete savings or sell assets to afford care.
  • Impact on Families: Financial toxicity extends beyond the patient to their families, leading to severe economic consequences. Families may resort to selling properties or skipping meals to manage treatment costs, which can entrap them in a cycle of generational poverty.
  • Out-of-Pocket Expenses: A significant portion of healthcare costs is borne out-of-pocket by patients. For example, outpatient expenses can account for nearly 50% of total healthcare costs, which are not covered by insurance schemes like Ayushman Bharat.

What are the contributing factors to financial toxicity in cancer care?

  • Inadequate Public Health Funding: India’s public health expenditure has historically been below 2% of GDP, resulting in insufficient healthcare infrastructure and personnel in public hospitals. This leads to delays in diagnosis and treatment, particularly for advanced cancer cases that require more costly interventions.
  • Limited Insurance Coverage: Existing insurance schemes primarily cover inpatient costs, leaving patients responsible for outpatient diagnostics and follow-up treatments. This gap significantly contributes to the financial burden on patients and their families.
  • Economic Disparities: Patients from low and middle-income backgrounds face additional hurdles in accessing cutting-edge treatments due to their high costs and limited availability in public health systems.

What are the steps taken by the Indian Government? 

  • Health Minister’s Cancer Patient Fund (HMCPF): Established in 2009 under the Rashtriya Arogya Nidhi, this fund provides financial assistance up to ₹5 lakh for cancer treatment at designated Regional Cancer Centers (RCCs).
    • In emergency cases, assistance can go up to ₹15 lakh. The fund aims to support patients living below the poverty line.
  • Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): This scheme offers health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization, including cancer treatments. It is designed for low-income families and is operational across India.
  • State-Specific Schemes: Various states have their own initiatives:
    • Arogyasri Scheme in Andhra Pradesh: Provides free cancer treatment for families with an annual income below ₹5 lakh.
    • Free Chemotherapy in Odisha: Offers free chemotherapy treatment at district hospitals for poor cancer patients.
    • Financial Assistance in Punjab: Up to ₹1.5 lakh is provided for cancer treatment to eligible residents.

What strategies can be implemented to mitigate financial toxicity? (Way forward)

  • Strengthening Public Healthcare: Increasing government investment in public health could improve access to affordable cancer care.
    • States like Delhi and Kerala have initiated schemes to support direct medical costs, but broader implementation is needed across India.
  • Supportive Measures for Non-Medical Costs: Initiatives such as discounted travel fares for cancer patients can alleviate some financial burdens associated with non-medical expenses. Expanding these programs could provide significant relief.
  • Role of Nonprofits and CSR: Nonprofit organizations play a crucial role in reducing out-of-pocket expenses through various support services. Increased funding from corporate social responsibility (CSR) initiatives could help these organisations expand their reach and impact.
  • Promoting Philanthropy: Encouraging individual philanthropy among wealthier segments of society could provide critical funding for cancer care initiatives and nonprofits focused on assisting low-income patients.
  • Policy Advocacy: Advocating for policies that address the gaps in insurance coverage and promote equitable access to cancer treatments is essential for reducing financial toxicity in the long term.

Mains PYQ:

Q What are the research and developmental achievements in applied biotechnology? How will these achievements help to uplift the poorer sections of the society? (UPSC IAS/2021)

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