It was announced by the Deputy Health Director-General (Medical) Datuk Dr S. Jeyaindran on last Saturday that the Health Ministry is reviewing the charge imposed on cancer patients in government hospitals.
It is not a secret that Health Ministry is facing uphill task in providing quality healthcare services with restricted resources, especially with increase in demand. However, an increase of the cancer treatment costs will affect many Malaysians as cancer is the number 4 disease killer in Malaysia.
On 4th April 2016, the investigators of the Asean Costs In Oncology (ACTION) study hosted a round table meeting with various stakeholders. One of the findings from the ACTION study in Malaysia revealed that 45% of the study population experienced financial catastrophe within a year following cancer diagnosis. Not only that, cancer mortality in Malaysia is higher than in developed countries as survival depends on optimal treatment, which can be costly.
The overall levels of catastrophic and impoverishing payments for cancer care are high for Malaysia. It is true that the current charge imposed at government hospitals is very minimum and fully subsidized, but these subsidies may not be sufficient, as it does not take into account the non-medical costs, such as loss of income, caregiver, transportation, food, etc.
According to Ministry of Health’s survey on cancer, the top five most common types of cancer in Malaysia are breast cancer, followed by colorectal, lung, cervical and nasopharyngeal. The treatment of each one of it can cost at a private hospital ranges from RM56,000 for lung cancer all the way to RM395,000 for higher breast cancer estimates.
Therefore, even if the proposed new rate is only 20 per cent of the actual costs of cancer treatment, the new charge can still be very impoverishing.
While reviewing the charge of cancer treatment, MOH should also look into the different mortality rates between MOH, academic and private hospital settings wherein the cancer mortality rates in MOH hospitals are higher.
Patients at academic hospitals, such as University Malaya Medical Centre, can be advised to obtain certain medications and/or medical devices if the hospital is unable to supply them. This, however, is not allowed in MOH hospitals. Therefore, even though the financial impact to the patients are higher, the survival or outcomes of patients treated in institutions like UMMC are better.
In total of 2013, only 4.45% of the country’s GDP is used for health expenditure. Out of the 4.54, only 4% is used for preventive measures while 62% is used for curative measures. A need to improve the financial risk protection for cancer patient is obvious and this would require re-examining health financing systems to ensure that public funds are channeled to those who need them most.