I

ndonesia will soon have its first set of data on the socioeconomic cost of cancer, a first step toward developing better cancer coverage for low-income families.

Health Minister Endang Rahayu Sedyaningsih said on Friday that the ministry had joined the second phase of the ASEAN CosTs In Oncology (ACTION) Study, a region-wide research into the socioeconomic impact of cancer in ASEAN communities.

Endang said that the socioeconomic cost of cancer was high not only for sufferers but for their families and the entire society. She said that it was high time to fully measure the socioeconomic burden of the disease.

“This study is important because we want to understand the economic cost of cancer, including the cost of illness. It’s in our interest to know how much money we have to spend to cover the costs of the disease,” she said during the launch of the second phase of the ACTION Study.

“It will not only examine direct costs related to medical treatment, expenses for buying cancer medicines but also its impact on health-related quality of life,” she added.

The region-wide study, aimed at mapping out the socioeconomic impacts of cancer, will involve
Indonesia and seven other ASEAN countries, namely Cambodia, Laos, Malaysia, Myanmar, the Philippines, Thailand and Vietnam.

According to 2007 Basic Research Health (Riskesdas), the prevalence-rate of tumor (including both cancer and tumor) reached 4.3 per 1,000 of the Indonesian population. Cancer ranks seventh as the leading cause of death after stroke, tuberculosis, hypertension, injury, perinatal complications and diabetes.

Hospital Information System (SIRS) data shows that breast cancer patients account for 18.4 percent of cases receiving in-patient medical treatment, followed by 10.3 percent for cervical cancer cases.

Endang said most cancer patients sought medical treatment when the disease was already at an advanced stage. “This means both low survival rates and heavier costs,” she said. Data from PT ASKES shows that cancer medical treatment for people receiving either in-patient or out-patient treatment ranked fourth in insurance disbursements paid by the company in 2010.

The Jamkesmas community health insurance scheme provides coverage for patients with cancer. With an allocated budget of only Rp 6,000 (US$0.67) per person per month, however, more measures are needed to deliver better coverage for cancer patients.

The study, Endang said, would provide proper information on the cost of cancer treatment for patients and their families. The data will be used to develop a proper coverage scheme under the BPJS Kesehatan effective from Jan.1, 2014.

The one-year study, funded by pharmaceutical giant Roche, will begin in January 2012 and involve 10,000 respondents. The survey will interview 2,400 cancer patients in Indonesia or about 25 percent of the total respondents.

“We will ask a series of questions of patients and give them a diary in which they can make notes about costs resulting from the disease,” said Hasbullah Thabrany, professor of public health at the University of Indonesia’s School of Public Health.

The notes, he said, would be used as guidelines in determining how much money should be spent on each cancer patient. Hasbullah said the survey would also see how cancer impacted the lives of patients’ families.

Mike Crichton, general manager of PT Roche Indonesia, said that the objective of the study was
to support the governments in several ASEAN member countries in developing an evidence-based oncology strategy.

“We believe that every country in the world deserves to have a comprehensive oncology strategy. It
will ultimately benefit the patients, enabling them to have the best treatment for this terrible disease. That is why it’s so worthwhile to work across ASEAN countries through the ACTION Study,” said Crichton.