http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-2.xsd
Cost of treatment of breast cancer in a specialized hospital, Nepal
ABSTRACT: Background: Breast cancer is a costly disease and imposes a large economic burden in many other low-and middle-income countries. There is a subsidy provided by Nepal government for cancer treatment which contributes NRs 1,00,000 through a scheme of support to impoverished citizen. However, there is no any study to assess if the subsidy is sufficient enough to prevent financial catastrophe in case of under-privileged patient. As per the literature survey, there is no any research done for estimation of cost of treatment of breast cancer in Nepal till date. Objectives: The general objective of the study is to appraise the economic burden of treatment of breast cancer and compare it with financial assistance provided by Nepal Government for cancer treatment under a scheme to support impoverished citizens. Method: This is a hospital based quantitative, retrospective study designed to estimate the cost of treatment for patient with breast cancer. The patient diagnosed with breast cancer visiting Nepal Cancer Hospital and Research Centre and admitted there were taken into consideration for the study. Only those patients with a confirmed diagnosis of breast cancer who had gone through treatment processes in National Cancer Hospital and Research Centre from January 2020 and December 2020 were included in the study. A structured data collection from (Annex 1) was used to enter data of patients from their prescription and other relevant medical data related to socio-demographic characteristics, type co cancer, stages of cancer, drug information, disease information, type of investigation and cost, laboratory investigation and cost, diagnosis and cost of treatment modalities (surgery, chemotherapy, hormonal therapy and radiotherapy). The data was entered in Microsoft Excel, analysis was done by using SPSS. Results: The mean and median total cost of treatment of breast cancer was estimated to be NRs 4,65,697.28 and NRs. 3,71,669.50 respectively with the total cost broadly ranging from NRs 1,11,951 to 18,37,122. In the case of treatment cost, the highest average cost incurred was for chemotherapy, at NRS. 2,02,912.81 and the range was also very wide (NRs. o to NRs. 14,11,209). The regime with trastuzumab was found to be the most expensive treatment option for chemotherapy. The lowest average treatment cost was for hormone therapy calculated for the duration of 5years, at NRs. 11,371.53 while the cost ranged from NRs. o to NRs.1,41,620. Cost of tamosifen oral tablet was comparatively much than other hormonal drugs like letrozole, anastrozole and exemestane. Chemotherapy costs made up the highest proportion (43.6%) of the total average cost of breast cancer treatment. Radiotherapy accounted for the second highest proportion (19.7%), followed by surgery (16.9%). Conclusion: Breast cancer impose a substantial economic burden on patients at private hospitals. Chemotherapy appeared to drive most of the cost of treatment of breast cancer. The financial assistance provided by Nepal Government for cancer treatment under a scheme to support impoverished citizens I not sufficient enough to prevent financial catastrophe in case of under-privileged patient. The present study is the first attempt of analysis will hopefully provide a useful source of information for future studies on support strategies for breast cancer patients and budget planning by concerned health authorities.