Cost determinant of chemotherapy in breast, cervical, and lung cancer in the era of National Health Insurance

Abstract

Introduction: This study focuses on the financial burden of treating breast, cervical, and lung cancer in Indonesia. The prevalence and mortality rates of this cancer, particularly in the context of the National Health Insurance program, are highlighted. The financial strain created by cancer treatment, its relationship to Universal Health Coverage goals, and the impact of the JKN initiative are discussed. Novelty: The originality of the study lies in exploring patient profiles, disease severity, and associated expenses, culminating in a comprehensive evaluation of medical expenses. Methods: This study used an analytic observational approach with a cross-sectional design, centered on the perspective of the Dharmais Cancer Center Hospital. The population consists of JKN patients diagnosed with breast, cervical and lung cancer. Data were collected retrospectively from JKN claim files and medical device records. Quantitative studies were conducted to understand the components of real costs, variations of chemotherapy, and the determinants of differences in costs. Statistical tests were used for data analysis. Results: This study involved 348 breast cancer patients, 306 cervical cancer patients, and 176 lung cancer patients undergoing chemotherapy in 2020. The distribution of patients by age group and cancer type was analysed, and disease characteristics were categorized by stage and severity using the Indonesian Case Base Groups (INA-CBGs) code. The cost analysis reveals the importance of accommodation, medicines, and medical equipment in terms of the overall expenditure. The cost of chemotherapy is very influential, and different treatment regimens are being explored for each type of cancer. Conclusion: This study underscores the important role of chemotherapy drugs, pharmaceutical costs, and medical devices in driving the overall cost of care. These insights contribute to informed decision making in healthcare policy and patient management, potentially reducing the financial burden faced by cancer patients. Recommendation: Further research and interventions can be designed based on these findings to optimize cancer treatment strategies and resource allocation.