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Cost of treatment of Cervical Cancer in a referral center in Nepal

Adhikari A.,Baral S., Silwal SR., Pandit S., Gauchan S., Jha AK.

04/10/2023

SFON-2013

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Nepal

• A country with 30 million people.• Low Income country.• GDP estimated to be NPR 130,000 per annum.• 50,000 to 70,000 cancer patients per year.1

• 28% of the total patients treated with radio-chemotherapy at BPKMCH were Cervical Cancer patients.2

1Piya MK, Acharya SC. Oncology in Nepal. South Asian J Cancer 2012;1:5-82 Department data: Dept. of Radiation Oncology, BPKMCH

04/10/2023 SFON-2013 3

Nepal

• 4 Centers with Teletherapy facility.

• 4 Centers with Brachytherapy facility.

• All of the centers within ~150 km range in a

country with a width of more than 1200 kms.

• Long travel, Long waiting list for the patients.

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BPKMCH

• BP Koirala Memorial Cancer Hospital, Chitwan

• Radiation Services started in 1999 AD

• Dedicated Cancer Center

• 2 linear accelerators with IMRT capability, HDR

Brachytherapy, Telecobalt machine.

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Methods

• Telephone interview

• 25 patients/families

• Those who had completed recently.

• Had received EBRT ± Chemotherapy followed

by brachytherapy

• Structured Questionnaire

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 250

10

20

30

40

50

60

70

80Patient Age

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Stage of Cervical Cancer

1

13

2

9

1B 2B

3A 3B

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Distance Travelled

0

100

200

300

400

500

600

700

262kms

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Number of Days Spent

Series1

0

20

40

60

80

100

120

140

160

180

200

103.8days

If there was no waiting, whole of the treatment would complete in 8 weeks.

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Cost Distribution (in NPR)

Radiation Charges Chemotherapy Fooding and Lodging.00

10000.00

20000.00

30000.00

40000.00

50000.00

60000.00

70000.00

80000.00

90000.00

10428.00 10640.00

88614.00

0 48000

30000 2160003000 22000

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Cost of Treatment

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

10428.00

10640.00

88614.00Series5

Fooding and Lodg-ing

Chemotherapy

=109682.00

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Conclusion

• The country needs more cancer centers to cater the

diverse population of Nepal.

• BPKMCH is doing its best to provide cervical cancer

treatment to the patients.

• Though the government is providing subsidy in ‘hospital

expenses’ – it hasn’t brought down the cost of cancer

treatment.

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Limitations

• Recall bias cannot be ignored.

• The amount said were in round figures.

• The decrease in family income because of

having more than 2 accompanying family

members hasn’t been considered.

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Thank you !