What can help make Breast cancer treatment a little more affordable in India?
“Cancer drugs may be most expensive in the USA, but Indians and Chinese have to stretch their pockets the maximum, in order to afford them”1,2
That was a piece of news that caught my attention earlier this month. At a recently concluded meeting1,2
(called ASCO 2016), experts compared prices of 23 cancer drugs in 6 different countries. And while cancer drugs were costliest in the USA, compared to India, China, Australia, South Africa and the UK, the drugs were least affordable in India and China (because “affordability” has to take into account the economic situation of the country and its people as well).
It’s news like this that makes you consider the immense cost of cancer. On the one hand is the tremendous physical and psychological cost for the person who is diagnosed, as well as the family and loved ones. And then there’s the tremendous financial burden linked to surgery, treatment, medicines and home-care—which is particularly daunting when you realize that over 80% of India has no health insurance, which means they need to pay from their own pockets.3
Treatment costs depend on several factors
That said, treatment costs can vary quite a bit though. Consider breast cancer, for example. The World Health Organization estimates that 145,000 women in India are diagnosed with breast cancer every year.4
Breast cancer treatments may often require up to 8 cycles of chemotherapy (with every cycle consisting of a treatment phase for 1-5 days, followed by a break for 3-4 weeks).5
But almost half of Indian patients cannot afford chemotherapy costs and stop visiting the hospital after just 2–3 chemotherapy cycles.4
According to an article in liveMint6 (2013), breast cancer surgery can cost INR 1.2 lakh in a private hospital. A more recent article7
(2015) pegged the cost of breast cancer treatment in the private setting, inclusive of investigations, surgery and radiotherapy, at INR 5-6 lakhs. Targeted therapy, which is one of the newer lines of treatment that can be very beneficial, often comes with a very steep price tag that ranges from INR 12-20 lakhs.7,8
And yet, there are quality institutes around the country that can offer breast cancer surgery at a mere INR 5000 and chemotherapy can cost INR 2500 per dose.6
But there’s a flip side to that. Because of the sheer number of people who have no choice but to opt for treatment in the public sector or in specialized institutes that charged subsidized rates, patients have to often endure day-long waits, in crowded waiting rooms, often with not much privacy. Understandably, even the consultation times are drastically shortened.
But there’s a glimmer of hope
But the eternal optimist in me wants to look for the silver lining. And there are quite a few.
For instance, last year, the government inaugurated AMRIT pharmacies (which stand for “Affordable Medicines and Reliable Implants for Treatment”) that will sell 202 cancer drugs (along with certain other medications) that will be 50–60% cheaper than those in the open market. Though these pharmacies are limited to a few locations for now, the plan is to have them in other parts of the country soon.4
In June this year, India’s National Pharmaceutical Pricing Authority (NPPA) reduced the prices of several important medicines, including the breast cancer drug Paclitaxel (metastatic breast cancer injectable) to INR 11,590 per vial.9
My hope is that the government continues these efforts and regulates more cancer treatment prices, just like the Australia and England governments do1
, in a way that benefits patients, while continuing to allow the major institutes and pharma companies to continue to fund the research they need to. Rose-coloured glasses? Maybe.
But why not.
- WebMD. U.S. Pays Highest Prices for Cancer Meds: Study. June 6, 2016. http://www.webmd.com/cancer/news/20160606/us-pays-highest-prices-for-cancer-meds-study
- Goldstein DA et al. Global differences in cancer drug prices: A comparative analysis. J Clin Oncol 34, 2016 (suppl; abstr LBA6500). http://meetinglibrary.asco.org/content/164423-176
- Bansal S. Health cover: Too little, too scarce. The Hindu. April 12, 2016. http://www.thehindu.com/sci-tech/health/policy-and-issues/health-insurance-in-india-too-little-too-scarce-reveal-national-sample-survey-data/article8462747.ece
- Press Information Bureau, Government of India. Health Minister opens AMRIT outlet at AIIMS for selling affordable drugs for cancer & heart diseases. November 15, 2015. http://pib.nic.in/newsite/PrintRelease.aspx?relid=130495
- Cancer Research UK. About breast cancer chemotherapy. August 1, 2014. http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/treatment/chemotherapy/about-breast-cancer-chemotherapy
- Gale J. Breast cancer surge in India means non-private exams for patients. liveMint. Oct 30, 2013. http://www.livemint.com/Politics/T0InitoEpqehyOVn0ZW4ZP/Breast-cancer-surge-in-India-means-nonprivate-exams-for-pat.html
- Mukerji C. Can you bear the cost of cancer treatment? Find out how to buy the best cover. ET Bureau. Jun 22, 2015. http://articles.economictimes.indiatimes.com/2015-06-22/news/63708670_1_cancer-treatment-globocan-2012-10-lakh-new-cases
- Rajan A. Why is Cancer Care expensive in India? ETHealthworld.com. April 16, 2015. http://health.economictimes.indiatimes.com/news/industry/why-is-cancer-care-expensive-in-india/46942857
- Raghavan P. Essential medicine for leukemia, stomach cancer to become cheaper in India. ET Bureau. Jun 07, 2016. http://economictimes.indiatimes.com/industry/healthcare/biotech/pharmaceuticals/essential-medicine-for-leukemia-stomach-cancer-to-become-cheaper-in-india/articleshow/52633695.cms