Lung Cancer Care In India: The Economic Burden Of Lung Cancer Treatment

Lung cancer is one of the most common cancers in India and the leading cause of cancer-related deaths. High tobacco use, air pollution, and occupational exposure to harmful chemicals contribute to the high incidence of lung cancer in the country. The financial burden of lung cancer care is a significant challenge for many families and can drive a large proportion of affected households into poverty.

Economic Problems Associated with Lung Cancer Treatment

Lung cancer treatment is expensive and involves multiple stages, from diagnosis to hospitalization and long-term supportive care. Below are the major financial burdens faced by patients and their families:

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1. Screening Programs

Ideally, patients at high risk of lung cancer should have it detected early via screening programs that are proven to improve survival. Even the cheapest screening modality (yearly low-dose CT scan) is expected to cost ₹3,000 - ₹4,000 per year, a significant amount for many families in India.

2. Need for Hospitalization and Cost of Supportive Care

Lung cancer treatment often requires hospitalization, which can be financially draining. In the private sector, the typical cost for these are as below:

• Hospitalization costs: ₹10,000 - ₹25,000 per day in private hospitals.
• ICU stay: ₹30,000 - ₹60,000 per day.

3. Expenses Related to Diagnosis

Accurate diagnosis of lung cancer requires multiple tests, leading to significant costs:

• Imaging tests (CT scans, PET-CT, X-rays): ₹5,000 - ₹25,000 per scan.
• Biopsy and histopathology tests: ₹10,000 - ₹30,000.
• Molecular and genetic testing: ₹20,000 - ₹50,000.
• Bronchoscopy and other procedures: ₹15,000 - ₹30,000.

Due to these high diagnostic expenses, many patients experience delayed diagnosis, resulting in higher stage and poorer survival.

4. Expenses Related to Treatment

The cost of lung cancer treatment depends on the stage of cancer and the chosen therapy. Major expenses include:

• Surgery: ₹2,00,000 - ₹5,00,000.
• Chemotherapy: ₹20,000 - ₹50,000 per cycle.
• Radiation therapy: ₹1,00,000 - ₹4,00,000, depending on the technique.
• Targeted therapy: ₹3,000 - ₹3,00,000 per month, depending on the specific drug used.
• Immunotherapy: ₹5,00,000 - ₹50,00,000 per year, depending on the drug used.

Currently Available Financial Support to Patients

1. Insurance and Government Schemes

• Ayushman Bharat (PMJAY): Offers up to ₹5,00,000 per family annually for treatment in empaneled hospitals.
• Employee State Insurance (ESI): Covers medical expenses for eligible workers.
• State-Specific Schemes: Some state governments provide financial aid, but benefits vary widely.
• Private Insurance: Some private health insurance plans cover cancer treatment, though expensive therapies such as immunotherapy may not be fully covered.
• Employer-Sponsored Health Plans (Eg. CGHS, ECHS, Private Employer Insurance): Some large corporations or institutions provide employee health benefits, including partial or full coverage for cancer treatment.

2. Patient Support Programs for Drug Access

Several pharmaceutical companies offer patient assistance programs to provide free or discounted cancer medications for those who qualify. For example, immunotherapy drugs which normally cost approximately 1 crore per year if purchased at MRP can cost a patient as little as 6 lakhs per year by taking advantage of these schemes. Most expensive anticancer drugs in India have some kind of patient support program available.

3. Fundraising and Crowdfunding

Many patients turn to crowdfunding platforms such as Milaap, Ketto, and ImpactGuru to raise money for treatment. Community-driven efforts and social media campaigns can help gather support from a larger audience.

4. Option of Joining Clinical Trials

Patients may consider participating in clinical trials, which can provide access to cutting-edge treatments at no cost. Many research hospitals and institutions in India offer trial programs for eligible lung cancer patients.

5. Other Support Mechanisms

• Hospitals with Charitable Wings: Some private hospitals have charitable programs to subsidize treatment costs for underprivileged patients.
• Government-Subsidized Generic Medicine Stores: Affordable chemotherapy and supportive drugs are available at Jan Aushadhi Kendras and other government-backed pharmacies.
• NGO and Community Support: Organizations like the Indian Cancer Society and CanKids provide financial and emotional support to cancer patients and their families.

Suggested Future Policy Changes to Support Lung Cancer Treatment in India

To reduce the financial burden of lung cancer treatment, India needs improved policies and stronger financial support mechanisms:

1. Expand Screening Programs: Free or subsidized lung cancer screening should be implemented for high-risk individuals.
2. Improve Insurance Coverage: Comprehensive insurance plans should include advanced treatments like immunotherapy and targeted therapy.
3. Increase Government Funding: More investment in government hospitals to provide affordable lung cancer treatment.
4. Centralized drug procurement and price negotiation can lower treatment costs by enabling bulk purchasing and securing reduced prices from pharmaceutical companies, ensuring affordability and accessibility of essential cancer medications. 
5. Public-Private Partnerships: Collaboration between the government and private healthcare providers to lower treatment costs.
6. Promote Domestic Drug Manufacturing: Encouraging local production of costly targeted therapy and immunotherapy drugs to reduce expenses.

In conclusion, lung cancer treatment in India presents significant financial challenges, but improved screening programs, better insurance coverage, and stronger government policies can enhance accessibility and affordability for patients. 

By:

Dr. Vineet Govinda Gupta

Additional Director & Unit Head Medical Oncology, Fortis Shalimar Bagh

This article is a part of Lung Connect India Foundation's initiative 'Lung Cancer Awareness - United In Our Goals', focusing on lung cancer prevention, diagnosis, and treatment.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.