Costs of breast cancer treatment incurred by women in Vietnam

Michael Donnelly,Nguyen Bao Ngoc,Ciaran O'Neill,Hoang Van Minh,Tran Thu Ngan

doi:10.1186/s12889-021-12448-3

Abstract

BackgroundThere is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam.MethodsIndividual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n = 202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics.Results19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2667). The mean OOP costs among patients with stage II and III BC were, respectively, 66 and 148% higher than stage 0/I.ConclusionsBC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by the use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programmes and by providing a higher insurance reimbursement rate for targeted therapy.

Highlights

Healthcare services including cancer treatment in Vietnam are financed via three main sources: government budget, social health insurance (SHI), and out-of-pocket (OOP) payments [1, 2]
As it was confined to an examination of cost from the public payer’s perspective (i.e., SHI and the government) [11], it offers limited insight into costs incurred by patients
Assessment of costs This study presents patient-reported direct payment to health care providers at time-of-service use which is the costs of breast cancer (BC) diagnosis and initial treatment (D&T) from a patient perspective

Summary

Introduction

Healthcare services including cancer treatment in Vietnam are financed via three main sources: government budget, social health insurance (SHI), and out-of-pocket (OOP) payments [1, 2]. Vietnam was ranked 46/186 countries in terms of the share of health expenditure from OOP which was higher than the 30% upper bound recommended by Breast cancer (BC) is the most common cancer among Vietnamese women with increasing incidence over time and the highest number of cancer-related deaths [6, 7]. The only study to examine the cost of BC care in Vietnam assessed the direct medical cost of treatment by category and stage of cancer [11]. As it was confined to an examination of cost from the public payer’s perspective (i.e., SHI and the government) [11], it offers limited insight into costs incurred by patients. There is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam

Methods

Results

Conclusion