Pilot study assessing the direct medical cost of treating patients with cancer in Kenya; findings and implications for the future

Abstract

Background: Currently the majority of cancer deaths occur in low- and middle-income countries, where there are appreciable funding concerns. In Kenya, most patients currently pay out of pocket for treatment, and those who are insured are generally not covered for the full costs of treatment. This places a considerable burden on households if family members develop cancer. However, the actual cost of cancer treatment in Kenya is unknown. Such an analysis is essential to better allocate resources as Kenya strives towards universal healthcare.

Objectives: To evaluate the economic burden of treating cancer patients.

Method: Descriptive cross-sectional cost of illness study in the leading teaching and referral hospital in Kenya, with data collected from the hospital files of sampled adult patients for treatment during 2016.

Results: In total, 412 patient files were reviewed, of which 63.4% (n = 261) were female and 36.6% (n = 151) male. The cost of cancer care is highly dependent on the modality. Most reviewed patients had surgery, chemotherapy and palliative care. The cost of cancer therapy varied with the type of cancer. Patients on chemotherapy alone cost an average of KES 138,207 (USD 1364.3); while those treated with surgery cost an average of KES 128,207 (1265.6), and those on radiotherapy KES 119,036 (1175.1). Some patients had a combination of all three, costing, on average, KES 333,462 (3291.8) per patient during the year.

Conclusion: The cost of cancer treatment in Kenya depends on the type of cancer, the modality, cost of medicines and the type of inpatient admission. The greatest contributors are currently the cost of medicines and inpatient admissions. This pilot study can inform future initiatives among the government as well as private and public insurance companies to increase available resources, and better allocate available resources, to more effectively treat patients with cancer in Kenya. The authors will be monitoring developments and conducting further research.

Keywords:

• Cancer
• Kenya
• direct medical costs
• medicine costs
• radiotherapy
• chemotherapy
• cost of illness

JEL classification codes:

• H51
• I18
• J18
• L33

Transparency

Declaration of funding

There was no external funding for this project.

Declaration of financial/other relationships

The authors declare they have no relevant conflicts of interest. There was also no writing assistance with this paper. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None reported.