Page 39 - Insurance Times February 2024

the treatment is taken, but still, the minimum price for The prevalence of CHE for hospitalization was highest
cancer treatment in India starts from Rs. 90,000. The amongst those who are not covered by any health
average cost of cancer treatment in India is Rs. 5,00,000 insurance scheme at 34.4% and was lowest for those
and the maximum charge for cancer treatment in India is covered by Ayushman Bharat at 16.01%.
up to Rs. 27,50,000. This cost is recurring as the duration of
treatment may extend to several years as many cancers Need for a separate Cancer Insurance
reoccur.
policy

Oncology medicines forming a major component of the Outpatient treatment which is the major cause of
treatment cost are quite expensive. Newer drugs due to catastrophic health expenditure and impoverishment in the
ongoing research in advanced cancer treatment are priced case of cancer treatment may not be fully covered in a
very high and are out of reach of many patients. The global hospitalization indemnity product, which is the major health
oncology drug market was valued at USD 184.95 billion and insurance product sold in the Indian market. Thus even if a
is projected to grow from USD 484.32 billion in 2023 to USD person is covered under health insurance, a large
484.32 billion by 2030. component of the cost has to be met out of pocket,
necessitating the need for a separate cancer insurance
Direct OOPE (Out of pocket expense) on policy.

cancer treatment Cancer treatment requires the patients to undergo many
A study on "Financial toxicity due to Cancer Treatment" different treatment modalities like surgery, chemotherapy,
published in July 2023 funded by the Department of Health radiotherapy, targeted therapy, immunotherapy, etc. which
Research, Ministry of Health and Family Welfare, financially drain them out. It is not only the medical cost of
Government of India reveals some striking facts about treatment but the life of caregivers i.e. the entire family is
cancer treatment. impacted. It may involve loss of income of the patient and
Per visit mean OOPE on outpatient cancer treatment caregivers, traveling and boarding expenses of patient and
was computed as Rs. 8,053. Taking into account the family, increased cost of nutrition, etc which exacerbates
average number of visits per month for outpatient the situation and acts as a barrier to access treatment.
treatment as 2.76, the mean monthly direct OOPE Moreover, there is a surge in the cost of complex cancer
incurred on outpatient treatment was estimated as Rs. surgeries/treatments every year.
22,227.
As per the economic survey 2022-23, the central and state
The major contributors of OOPE for outpatient
governments’ budgeted expenditure on healthcare was 2.1
treatment were diagnostic - 36.4% and medicines -
% of GDP in FY23 and 2.2% in FY22, against 1.6% in FY21.
27.8%
Besides this, only 37 % (52.04 Crores) of India’s population
The estimated OOPE per episode of hospitalization was is covered under any sort of health insurance, which includes
Rs. 39,085. The total annual direct OOPE on cancer all forms of private, employer-based, and government-
treatment was estimated at Rs. 331,177. sponsored health insurance schemes.
In the case of hospitalized treatment, medicines were
the major component at 45% followed by diagnostics
at 16.4%, and procedure/surgery formed only 12.1% of
the major contributors to OOPE.

The economic impact of cancer care on household
financial risk protection using standard indicators of
catastrophic health expenditures (CHE) and
impoverishment indicated that the overall prevalence
of CHE and impoverishment for outpatient treatment
was 80.4% and 67% respectively as compared to
hospitalization treatment (it was 29.8% and 17.2%
respectively). Thus, it is not the hospitalization cost that
is creating financial strain but the outpatient cost of
cancer treatment.

36 February 2024 The Insurance Times