Financial Toxicity of Cancer in China

Abstract

Background and context: Cancer is not only a medical problem, but also a socioeconomical issue as the high prevalence with poor prognosis brings heavy financial burden to the society. From 2005 to 2013, the incidence and mortality rates have sharply increased in China. The most common types of cancer in males in China are lung cancer, gastric cancer, and liver cancer while breast cancer, lung cancer, colorectal cancer are the major types of cancer among Chinese females. The prognosis for most types of cancer is poor and the treatment costs have been high and hence cancer has caused significant financial burden on patients and negatively impacted their lives. Since the 1970s, Chinese government has been paying attention to cancer burden and applying the nationwide cancer management strategy. Population-based cancer screening, public health education of cancer prevention and treatment on general population, and catastrophic disease medical insurance policy providing additional funding for cancer treatments have been widely implemented in the country. However, cancer in China still imposes the greatest financial burden on the patients, the families, and the society. It is imperative for the Chinese government to develop effective policies to address the financial toxicity of cancer in China. Aim: Through analyzing the data, we introduce and explain how Chinese government implements cancer control strategy in recent decades and how the national health insurance policies work on curing cancer disease. Strategy/Tactics: With presenting the available data from 2005 to 2013, we analyze the overall prevalence trend of cancer incidence and mortality in China. In terms of cost, we analyze the overall inpatient cost, inpatient expenses on the most common cancers, and anticancer pharmacies to explain the economic loss that cancer caused to Chinese people. Program/Policy process: Considering the alarming prevalence and economic burden of cancer, China has been paying attention to cancer prevention and treatment and conduct national cancer plans and insurance policies. The plans focused on taking actions to lower cancer burden in high risk groups and regions, strengthening public education and professional training, and promoting cancer standardized treatment guidelines in the nation. Insurance policies were emphasized on critical disease health coverage, including cancer. Outcomes: To mitigate the situation where patients have become indigent due to critical diseases, since 2012, the Chinese government has issued the Critical Disease Insurance Policy to provide financial assistance through supplementary insurance to patients who have incurred a critical disease such as pediatric leukemia, lung cancer, and cervical cancer. What was learned: We learned how Chinese national cancer prevention plans and health insurance policies were efficient worked in releasing the cancer prevalence trend and decreasing the economic cost in recent decades.