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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 763-764

The apt way forward to reduce the economic burden is enhancing utilization amongst eligible beneficiaries


1 Department of Community Medicine, IGMC, Shimla, Himachal Pradesh, India
2 Department of Radio-diagnosis, IGMC, Shimla, Himachal Pradesh, India

Date of Submission18-Nov-2021
Date of Decision23-Nov-2021
Date of Acceptance24-Nov-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Gopal Ashish Sharma
Department of Community Medicine, IGMC, Shimla - 171 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_296_21

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How to cite this article:
Sharma GA, Barwal VK, Kapila S. The apt way forward to reduce the economic burden is enhancing utilization amongst eligible beneficiaries. Cancer Res Stat Treat 2021;4:763-4

How to cite this URL:
Sharma GA, Barwal VK, Kapila S. The apt way forward to reduce the economic burden is enhancing utilization amongst eligible beneficiaries. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Jan 20];4:763-4. Available from: https://www.crstonline.com/text.asp?2021/4/4/763/334227



The article titled, “Economic and non-economic burden of cancer: A propensity score-matched analysis using household health survey data of India,” published in Cancer Research, Statistics, and Treatment about out-of-pocket expenditure (OOPE) piqued our interest. This paper, authored by Dr. Goyanka, brought forth the pertinent question of the cataclysmic nature of the economic costs incurred on cancer diagnosis, treatment, and their subsequent impact on living.[1] We would like to highlight one of the critical aspects of this significant economic burden and possible ways forward for redressal in the near future by various policymakers.

Propensity score matching showed that the odds ratios in both groups (inpatient and outpatient cancer care) were higher for those living in the rural areas; this was one of the key findings of this study. Moreover, in the matched sample analysis for the inpatient hospitalization of patients, the mean OOPE for cancer care in a private facility was observed to be significantly higher (2.5 times) than that in a public facility. Expenditure incurred for “all chronic ailments” and “high OOPE chronic ailments” was also reported to be on the higher side for a private facility. According to World Bank staff estimates based on the United Nations Population Division's World Urbanization Prospects: 2018 Revision, 65.07% of the population of India is still dwelling in the rural areas.[2] India launched its flagship health insurance scheme, “Ayushman Bharat Pradhan Mantri Jan Arogya Yojana” (ABPM-JAY), on September 23, 2018. The financial risk protection offered by the scheme is worth ₹500,000 annually, covering secondary and tertiary care for the poorest and most vulnerable families.[3] The estimated number of beneficiaries to be covered under this scheme is 0.5 billion. However, as of November 12, 2021, only 0.168 billion golden cards were generated for eligible beneficiaries since the scheme's launch 3 years ago.[4],[5] There is a striking deficit of 66.7% of entitled beneficiaries who are being left out from risk protection, probably due to logistical inaccessibility or lack of awareness in the rural settings. A systematic, planned, and dedicated awareness drive is the need of the hour to accentuate the utilization coverage of AB-PMJAY, specifically in states lagging in registrations. In addition, those left out of the umbrella of AB-PMJAY can be offered similar coverage for financial risk under other schemes, such as the Himachal Pradesh Swasthya Bima Yojana Society (HIMCARE), a schematic replica of ABPM-JAY by the state of Himachal Pradesh, India.[6] The state of Himachal Pradesh is predominantly inhabited by rural communities, and extension of financial risk protection to those left-out through HIMCARE is a step in the right direction to cover one of the components of costs incurred under universal health coverage.[7]

To conclude, the expenditure incurred is catastrophic in diseases like cancer,[8] especially in those requiring hospital admissions. The much-needed financial risk covers for indoor care are available; it is time to actively engage every stakeholder, be it the beneficent family or the health-care system, for enhancing the utilization among those who need them. The holistic burden can be attenuated by making available financial risk coverage to all eligible patients at a quicker pace.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Goyanka R. Economic and non-economic burden of cancer: A propensity score matched analysis using household health survey data of India. Cancer Res Stat Treat 2021;4:29-36.  Back to cited text no. 1
  [Full text]  
2.
United Nations, Department of Economic and Social Affairs, Population Division. World Urbanization Prospects: The 2018 Revision (ST/ESA/SER.A/420). New York: United Nations; 2019.  Back to cited text no. 2
    
3.
Radhakrishnan V. Drug pricing: A major barrier to access to cancer care in India. Cancer Res Stat Treat 2021;4:195-7.  Back to cited text no. 3
  [Full text]  
4.
Ayushmann Cards Status. Available from: https://pmjay.gov.in/. [Last accessed on 2021 Nov 15].  Back to cited text no. 4
    
5.
Prinja S, Gupta N. Value-based pricing for cancer drugs in India. Cancer Res Stat Treat 2021;4:559-60.  Back to cited text no. 5
  [Full text]  
6.
The Himachal Health Care Scheme; 2019. Available from: https://hpsbys.in/scheme/ecLCGV0$329zmDGQQ54zvJ$sWcxcGC-N6juGfzLzfGI_. [Last accessed on 2021 Nov 15].  Back to cited text no. 6
    
7.
Sharma GA, Kapila S. Himachal Pradesh – A hilly state of India on path of – Universal health coverage. Int J Noncommun Dis 2019;4:53-5.  Back to cited text no. 7
    
8.
Gupta A, Gyawali B. Digging deeper into cancer-associated financial toxicity in low- and middle-income countries. Cancer Res Stat Treat 2021;4:172-3.  Back to cited text no. 8
  [Full text]  




 

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