Cost of treatment of Cervical Cancer
in a referral center in Nepal

SFON-2013

12/14/2013

Adhikari A.,
Baral S., Silwal S...
Nepal
•
•
•
•
•

1Piya

A country with 30 million people.
Low Income country.
GDP estimated to be NPR 130,000 per annum.
5...
Nepal
• 4 Centers with Teletherapy facility.

• 4 Centers with Brachytherapy facility.
• All of the centers within ~150 km...
BPKMCH
• BP Koirala Memorial Cancer Hospital, Chitwan
• Radiation Services started in 1999 AD
• Dedicated Cancer Center
• ...
Methods
• Telephone interview
• 25 patients/families
• Those who had completed recently.
• Had received EBRT ± Chemotherap...
Patient Age
80
70
60
50
40
30
20
10

0

12/14/2013

SFON-2013

6
Stage of Cervical Cancer
1
9

1B
13

2B
3A

2

12/14/2013

3B

SFON-2013

7
Distance Travelled
700
600
500
400
300

262kms

200
100
0
12/14/2013

SFON-2013

8
Number of Days Spent
200
180
160
140
120

103.8days

100
80
60
40
20
0
If 12/14/2013 no waiting, whole of the treatment wo...
Cost Distribution (in NPR)
90000.00
80000.00
70000.00
60000.00
50000.00

88614.00

40000.00
30000.00
20000.00
10000.00

10...
Cost of Treatment
100%

90%
80%

70%

Fooding and
Lodging

88614.00

60%

Chemotherapy

50%
40%

Radiation Charges

30%
20...
Conclusion
• The country needs more cancer centers to cater the
diverse population of Nepal.
• BPKMCH is doing its best to...
Limitations
• Recall bias cannot be ignored.
• The amount said were in round figures.
• The decrease in family income beca...
Thank you !
12/14/2013

SFON-2013

14
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Cancer Treatment Cost in Nepal

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The presentation on Cost of Treating Carcinoma Cervix in Nepal.

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Cancer Treatment Cost in Nepal

  1. 1. Cost of treatment of Cervical Cancer in a referral center in Nepal SFON-2013 12/14/2013 Adhikari A., Baral S., Silwal SR., Pandit S., Gauchan S., Jha AK. 1
  2. 2. Nepal • • • • • 1Piya A country with 30 million people. Low Income country. GDP estimated to be NPR 130,000 per annum. 50,000 to 70,000 cancer patients per year.1 28% of the total patients treated with radiochemotherapy at BPKMCH were Cervical Cancer patients.2 MK, Acharya SC. Oncology in Nepal. South Asian J Cancer 2012;1:5-8 2 Department data: Dept. of Radiation Oncology, BPKMCH 2
  3. 3. Nepal • 4 Centers with Teletherapy facility. • 4 Centers with Brachytherapy facility. • All of the centers within ~150 km range in a country with a width of more than 1200 kms. • Long travel, Long waiting list for the patients. 12/14/2013 SFON-2013 3
  4. 4. BPKMCH • BP Koirala Memorial Cancer Hospital, Chitwan • Radiation Services started in 1999 AD • Dedicated Cancer Center • 2 linear accelerators with IMRT capability, HDR Brachytherapy, Telecobalt machine. 12/14/2013 SFON-2013 4
  5. 5. Methods • Telephone interview • 25 patients/families • Those who had completed recently. • Had received EBRT ± Chemotherapy followed by brachytherapy • Structured Questionnaire 12/14/2013 SFON-2013 5
  6. 6. Patient Age 80 70 60 50 40 30 20 10 0 12/14/2013 SFON-2013 6
  7. 7. Stage of Cervical Cancer 1 9 1B 13 2B 3A 2 12/14/2013 3B SFON-2013 7
  8. 8. Distance Travelled 700 600 500 400 300 262kms 200 100 0 12/14/2013 SFON-2013 8
  9. 9. Number of Days Spent 200 180 160 140 120 103.8days 100 80 60 40 20 0 If 12/14/2013 no waiting, whole of the treatment would complete in 8 weeks. there was SFON-2013 9
  10. 10. Cost Distribution (in NPR) 90000.00 80000.00 70000.00 60000.00 50000.00 88614.00 40000.00 30000.00 20000.00 10000.00 10428.00 10640.00 .00 Radiation Charges 3000 12/14/2013 22000 Chemotherapy 0 48000 SFON-2013 Fooding and Lodging 30000 216000 10
  11. 11. Cost of Treatment 100% 90% 80% 70% Fooding and Lodging 88614.00 60% Chemotherapy 50% 40% Radiation Charges 30% 20% 10640.00 10% 10428.00 0% =109682.00 12/14/2013 SFON-2013 11
  12. 12. Conclusion • The country needs more cancer centers to cater the diverse population of Nepal. • BPKMCH is doing its best to provide cervical cancer treatment to the patients. • Though the government is providing subsidy in ‘hospital expenses’ – it hasn’t brought down the cost of cancer treatment. 12/14/2013 SFON-2013 12
  13. 13. Limitations • Recall bias cannot be ignored. • The amount said were in round figures. • The decrease in family income because of having more than 2 accompanying family members hasn’t been considered. 12/14/2013 SFON-2013 13
  14. 14. Thank you ! 12/14/2013 SFON-2013 14
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