Chauhan Akashdeep Singh, Prinja Shankar, Ghoshal Sushmita, Verma Roshan, Oinam Arun S
School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
PLoS One. 2018 Jan 11;13(1):e0191132. doi: 10.1371/journal.pone.0191132. eCollection 2018.
There are no published data on the cost of cancer treatment for guiding reimbursement decisions in India. The present study was designed to estimate the cost of treating head and neck cancer (HNC) with the aim of determining package rates. The present study was undertaken in the Departments of Radiotherapy and Otolaryngology of a large tertiary care hospital in North India. Economic health system costs incurred were assessed using a bottom-up methodology. Data on all resources-capital or recurrent, incurred on the delivery of HNC treatment were collected from April 2014 to March 2015. Following the cost-of-illness approach, patients were interviewed to elicit out-of-pocket (OOP) expenditure. A total of INR 40,993,017 (USD 0.67 million) was spent on radiotherapy care for treating HNC during 1 year. Salaries constituted the major component (42.6%) of this cost, followed by equipment/furniture (29%), space rent (20.7%), overheads and consumables (7.7%). In addition, INR 47,191 (USD 773) per HNC patient was spent on the surgery. Furthermore, patients spent an average amount ranging from INR 12,575 (USD 206) to INR 65,257 (USD 1069) on the different treatment therapies. In terms of package rates, cobalt radiotherapy alone was the cheapest (INR 38,714, USD 634), while intensity modulated radiotherapy (IMRT) was most expensive (INR 192,914, USD 3161). The estimates from the present study could be used for developing package rates under various publicly financed health insurance schemes as well as for the planning for creation of new cancer centres.
在印度，目前尚无关于癌症治疗成本的公开数据可用于指导报销决策。本研究旨在估算头颈部癌（HNC）的治疗成本，以确定套餐价格。本研究在印度北部一家大型三级护理医院的放疗科和耳鼻喉科进行。采用自下而上的方法评估所产生的经济卫生系统成本。收集了2014年4月至2015年3月期间头颈部癌治疗所产生的所有资源成本（资本成本或经常性成本）。按照疾病成本法，对患者进行访谈以获取自付费用。在1年期间，用于头颈部癌放疗护理的总费用为40,993,017印度卢比（67万美元）。工资占该成本的主要部分（42.6%），其次是设备/家具（29%）、场地租金（20.7%）、间接费用和耗材（7.7%）。此外，每位头颈部癌患者的手术费用为47,191印度卢比（773美元）。此外，患者在不同治疗方法上的平均花费在12,575印度卢比（206美元）至65,257印度卢比（1069美元）之间。就套餐价格而言，仅钴放疗最便宜（38,714印度卢比，634美元），而调强放疗（IMRT）最昂贵（192,914印度卢比，3161美元）。本研究的估算结果可用于制定各种公共资助医疗保险计划下的套餐价格，以及规划创建新的癌症中心。
