Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study

Autor: Helen Monaghan, Phetsamone Arounlangsy, Catharina Suharti, Soe Aung, Heng Viroath, Khanh Quach Thanh, Nirmala Bhoo-Pathy, Myo Khin, Irisyl Orolfo-Real, Eav Sokha, Trang Ngo Thuy, Stephen Jan, Khoa Mai Trong, Pujianto, Cheng-Har Yip, Conrado Lola, Soe Oo Maung, Sonar S. Panigoro, Richard Sullivan, Le Le Win, Djumhana Atmakusuma, Merel Kimman, Mark Woodward, Khin May Oo, Dradjat R. Suardi, Abdul Muthalib, Somphob Sangkittipaiboon, Chiu Wan Ng, Ario Djatmiko, Kouy Samnang, Thanut Khuayjarernpanishk, Dieu Bui, Huy Phạm Quang, Dhanoo Lawbundis, Corazon A. Ngelangel, Yin Yin Htun, Soledad L. Balete, San Shwe, Bounthaphany Bounxouei, Htun Lwin Nyein, Tuan Diep Bao, Jay Datukan, Loan Dang Thi Kim, Kitisak Thepsuwan, Hasbullah Thabrany, Dung Pham Xuan, Leo Marbella, Darunee Suanplu, Gloria Cristal-Luna, Cherelina Santiago-Ferreras, Suleeporn Sangrajrang, Tin Moe Win, Tawin Klinwimol, Swe Swe Win, Seang Pharin, Jitraporn Tanabodee, Ami Ashariati, Cheng Har Yip, Ha Tran Dinh, Prasit Khopaibul, Khoa Tran Dang, Nga Nguyen Thi Hoai, Annielyn Beryl Ong-Cornel, Suyatno, Thiravud Khuhaprema, Agnes E. Gorospe, Thanadej Sinthusake, I.Made Bakta, Somkiet Lalitwongsa, Win Pa Pa Naing, Pik-Pin Goh, Andi Fachruddin, Phung Dang Thi Ngoc, Aru W. Sudoyo, Oudayvone Rattanavong, Thao Nguyen Hoang, Prih Sarnianto, Sanne A.E. Peters, Shu Mon, Shridevi Subramaniam, Johan Kurnianda
Přispěvatelé: MUMC+: KIO Kemta (9), RS: CAPHRI - R2 - Creating Value-Based Health Care
Rok vydání: 2016
Předmět:
Zdroj: European Journal of Cancer, 74, 26-37. ELSEVIER SCI LTD
ISSN: 1879-0852
0959-8049
Popis: Background: Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC).Methods: The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs >= 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes.Results: The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4 9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages.Conclusion: The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor. (C) 2017 Elsevier Ltd. All rights reserved.
Databáze: OpenAIRE
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