Cancer driven direct medical costs in Bangladesh: Evidence from patient perspective

Cancer treatment costs are rising, and the disease is becoming a major challenge to healthcare systems in developing countries like Bangladesh. The direct medical costs of cancer have yet to be comprehensively studied in the country. Hence, the study aimed to estimate the direct medical costs associated with cancer from patients' perspective.

This cross-sectional study was conducted in two tertiary specialised cancer hospitals. Data on direct medical costs incurred during treatment in the last three months were collected. The average per-patient costs for cancer treatment were computed and stratified by cancer sites, stages, and types of health facilities. A generalised linear model was used to test the mean cost difference in healthcare services by cancer sites, stages, and type of health facility.

Overall, the per-patient direct medical costs were BDT 41,019 (US$477), with 33 % allocated to hospitalisation (BDT 13,420; $156) followed by 29 % for surgery (BDT 11,833; $138). Patients with gallbladder (BDT 94,722; $1101), brain (BDT 82,608; $961), and esophageal cancer (BDT 82,556; $960) had the highest average treatment costs. The mean costs per patient were BDT 42,050 ($489), BDT 40,583 ($472), BDT 40,892 ($475), BDT 38,252 ($445) and BDT 53,306 ($620) for disease stages 0, I, II, III, and IV, respectively. The costs increased by 0.63 % from stage I to II but decreased by 7 % from stage II to III while rising sharply by 39 % from stage III to IV. The costs for patients with gallbladder, pancreatic and brain cancer were significantly higher at BDT 51,194 ($595), BDT 43,637 ($507) and BDT 39,338 ($457) compared to patients with oral cancer, respectively. On average, per-patient costs were 5 % higher in private health facility (BDT 42,947; $499) compared to public hospital (BDT 40,743; $474).

This study reveals that cancer treatment costs are high in advanced stages and in private hospital. The findings suggest that earlier diagnosis and financial subsidies may help curb the ongoing high cancer treatment costs.