Department of Surgery, Division of General Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Surgery, College of Health Sciences, Obafemi Awolowo University (OAU), Ile-Ife, Nigeria.
Pan Afr Med J. 2022 Apr 5;41:272. doi: 10.11604/pamj.2022.41.272.24610. eCollection 2022.
in Nigeria, the incidence of breast cancer has increased by over 80% in the last four decades. This study quantifies the out-of-pocket (OOP) cost of breast cancer management and the associated rate of catastrophic healthcare expenditure (CHE) at a public tertiary care facility in Ile-Ife, Nigeria.
patients treated between December 2017 - August 2018 were identified from a prospective breast cancer database. A questionnaire was developed to capture the total cost of care, including direct and indirect expenses. Three commonly used thresholds for a CHE were used in this analysis. The cost of radiotherapy and targeted therapy were captured separately.
data was collected from 22 eligible patients. Sixty-eight percent had no form of health insurance. The mean cost of diagnosis and treatment was $2,049 (SD $1,854). At a threshold of 10% and 25% of annual income, 95% and 86% of households experienced a CHE. Based on a household´s capacity-to-pay, 90% experienced a CHE. The mean cost of radiotherapy was $462 (SD $223) and the mean cost of trastuzumab was $6,568 (SD $2,766). Cost precluded surgery in 14% of patients with resectable disease. As a result of accessing treatment, 72% of households had to borrow money and 9% of households interrupted a child´s education.
the out-of-pocket cost of breast cancer care in Nigeria is significant. This results in a CHE for 68-95% of households, which has significant health and economic sequelae. Greater financial protection is essential as the burden of breast cancer increases in Nigeria.
在过去的四十年中，尼日利亚的乳腺癌发病率增加了 80%以上。本研究定量评估了尼日利亚伊费市一家公立三级保健机构乳腺癌管理的自费（OOP）费用和相关灾难性医疗支出（CHE）率。
从前瞻性乳腺癌数据库中确定了 2017 年 12 月至 2018 年 8 月期间接受治疗的患者。开发了一份问卷，以获取包括直接和间接费用在内的总护理费用。本分析使用了三种常用的 CHE 阈值。单独捕获了放射治疗和靶向治疗的费用。
共收集了 22 名符合条件的患者的数据。68%的患者没有任何形式的医疗保险。诊断和治疗的平均费用为 2049 美元（标准差为 1854 美元）。在阈值为 10%和 25%的年收入时，95%和 86%的家庭发生 CHE。基于家庭的支付能力，90%的家庭发生 CHE。放射治疗的平均费用为 462 美元（标准差为 223 美元），曲妥珠单抗的平均费用为 6568 美元（标准差为 2766 美元）。由于无法支付费用，14%的可切除疾病患者无法进行手术。为了接受治疗，72%的家庭不得不借钱，9%的家庭中断了孩子的教育。
在尼日利亚，乳腺癌治疗的自费费用很高。这导致 68-95%的家庭发生 CHE，这对健康和经济产生了重大影响。随着尼日利亚乳腺癌负担的增加，需要更多的财务保护。
