Orlando Harmon
Cancer is a leading cause of death in China, and the financial burden of treatment falls heavily on patients and their families. While the Chinese government has committed to improving healthcare accessibility and affordability, the high cost of cancer treatment remains a significant challenge for many. This is especially true for those in rural areas, where medical care is less advanced and accessible than in large coastal cities. The government has implemented various insurance schemes, such as the Urban Employees' Basic Medical Insurance Scheme (UEBMI), to provide financial protection, but out-of-pocket expenses can still be substantial, leading to inadequate healthcare or even a complete lack of treatment. As a result, cancer patients in China often face difficult choices and significant financial strain when seeking treatment.
| Characteristics | Values |
|---|---|
| Number of cancer patients | One of the largest numbers of cancer patients worldwide |
| Cancer patients with insurance | Many patients have no insurance or inadequate insurance |
| Cancer treatment costs | Very high, imposing a heavy economic burden on patients and their families |
| Cancer as a cause of death | Accounts for one-fifth of total deaths in China |
| Government initiatives | Established multi-level medical security system including universal healthcare system, commercial medical insurance, and medical charity aid |
| Universal healthcare system | Covers basic medical insurance, urban and rural medical assistance, serious illness aid, critical illness insurance, etc. |
| Insurance reimbursement | Varies according to cancer patients' type of healthcare insurance, medical costs, and current income level |
| Innovative anti-cancer medicines | Low availability in hospitals, despite improved affordability due to NHIC policy |
| Cancer prevention | Not funded by the current health insurance system, but the government has increased funding for prevention and early detection |
| Cancer drug marketing | Requires understanding of China's evolving healthcare system, regional economic gaps, and treatment costs |
| Cancer-specific insurance plans | Offered by most companies, providing a fixed amount of compensation |
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What You'll Learn
Cancer treatment costs
An empirical study by the National Cancer Centre in 2016 revealed that the treatment cost per cancer patient in China was US$9,739, while the average household income in the same year was US$8,607. This disparity highlights the financial strain faced by those battling cancer. Another study in Inner Mongolia found that the annual direct medical cost for cancer patients exceeded CNY 86,100 after basic medical insurance reimbursement. This amount surpassed the threshold for "catastrophic health expenditure" set by the World Health Organization (WHO), further underscoring the financial and mental strain on patients and their families.
The cost of cancer treatment in China varies depending on the type of cancer and the stage at which it is diagnosed. For example, the average cost for lung cancer treatment in 2021 was around 39,500 yuan, while treatments for other cancers, such as oesophageal and bladder cancer, tended to be lower in cost. Additionally, treatments for late-stage cancers (stages III and IV) are generally more expensive than early-stage treatments (stages I and II) due to longer hospitalizations and more costly therapies like radiotherapy, chemotherapy, and targeted therapy.
The Chinese government has implemented a multi-level medical security system, including universal healthcare, commercial medical insurance, and medical charity aid, to ensure that everyone has access to healthcare. This system provides basic medical insurance reimbursement, serious illness insurance compensation, and urban and rural medical relief for cancer patients, with varying levels of coverage depending on factors such as income and type of insurance. However, out-of-pocket expenses can still be substantial, and the availability of innovative anti-cancer medicines in hospitals remains low, impacting the overall affordability of cancer treatment in China.
The financial burden of cancer treatment in China is not limited to direct medical costs. Patients with late-stage cancer and their caregivers experience significant time loss, resulting in indirect costs that further compound the economic impact. Additionally, cancer prevention and early detection initiatives are crucial in reducing cancer-related deaths, but the current health insurance system does not provide funding for preventive measures, creating obstacles to implementing preventive medicine.
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Availability of insurance
China has a multi-level medical security system that includes universal healthcare, commercial medical insurance, and medical charity aid. The universal healthcare system is the main form of healthcare in China and is used by over 95% of the population. It includes basic medical insurance, urban and rural medical assistance, serious illness aid, and critical illness insurance.
The Chinese government has made efforts to improve the affordability of healthcare for cancer patients. For instance, the Urban Employees' Basic Medical Insurance Scheme (UEBMI), established in 1997, covers employees and retirees in urban areas through shared premiums between employees and employers. The UEBMI has considerably reduced the economic burden of insured cancer patients, especially in Shanghai and Beijing.
However, there are still many Chinese citizens who do not have health insurance or have inadequate coverage. In these cases, patients must pay out-of-pocket, which very few can afford, or settle for less service, resulting in inadequate healthcare. This issue is particularly pronounced in rural areas of China, where cancer patients may face challenges in accessing comprehensive or long-term care.
Furthermore, the availability of innovative anti-cancer medicines in hospitals remains low, and the utilisation of these medicines is affected by factors such as the incidence of cancer and the limitations of insurance programs. For example, a one-month supply of Gleevec, a medication for treating leukemia, costs over CNY 23,000 and is not covered by health insurance in most Chinese cities.
To address these challenges, the Chinese government has initiated strategies such as price negotiations with pharmaceutical companies and increasing funding for cancer prevention and early detection. Additionally, most companies in China offer cancer-specific insurance plans that provide a predetermined fixed amount of compensation. These plans aim to provide financial protection and improve the affordability of cancer treatments for insured patients.
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Affordability of medicines
Cancer is a major public health concern in China, with the country accounting for 21.9% of new cancer cases and 26.8% of cancer deaths worldwide. The high cost of cancer treatment has become a significant issue in China, with the average treatment cost per patient exceeding the average household income. This has resulted in a heavy economic and mental burden on patients and their families, with many giving up treatment due to financial constraints.
China has a universal healthcare system that includes basic medical insurance, urban and rural medical assistance, serious illness aid, and critical illness insurance. By the end of 2014, over 95% of the Chinese population was covered by basic medical insurance. Poor patients with malignant tumors can receive basic medical insurance reimbursement, serious illness insurance compensation, and medical relief. However, the availability and affordability of innovative anti-cancer medicines remain a concern. The inclusion of expensive targeted anti-cancer medicines in government health insurance coverage has improved their utilisation and affordability, but the financial burden on patients remains high.
The Chinese government has taken steps to address the affordability issue by exempting tariffs on imported cancer drugs, initiating centralised negotiations and procurement, and incorporating more cancer drugs into the medical insurance reimbursement catalogue. They have also proposed a long-term strategy to control cancer drug pricing by encouraging new drug discovery, accelerating approval procedures, reducing circulation costs, and improving cancer diagnosis and rational drug use.
Despite these efforts, cancer drug prices in China remain among the least affordable globally. The high prices are partly due to China's heavy reliance on imported medicines, which account for half of its anticancer medicine sales. There is also a disparity in affordability between high-income and low-income regions, with patients in low-income areas facing greater challenges in accessing affordable treatments.
To further improve affordability, it has been suggested that governments should use their bargaining power to reduce procurement prices and abolish taxes on anticancer medicines. A special health insurance plan for low-income cancer patients could also help ensure access to treatment. Additionally, increasing investment in cancer prevention and early detection can play a crucial role in reducing the financial burden on patients and the healthcare system.
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Financial burden on patients
Cancer patients in China face a heavy financial burden due to the high cost of treatment. The cost of cancer treatment in China has become a major issue in social security, with many patients and their families struggling to afford the necessary care. This is a significant problem, as China has one of the largest numbers of cancer patients worldwide, with cancer accounting for one-fifth of total deaths in the country.
The high cost of cancer treatment in China is due to several factors, including the high price of innovative drugs and advanced treatments, as well as the limited availability of these treatments under the national health insurance plan. While the Chinese government has made efforts to improve access to healthcare and provide financial protection for cancer patients, the financial burden remains high. For example, a 1-month supply of Gleevec, a leukemia medication, costs over CNY 23,000 and is not covered by health insurance in most Chinese cities. As a result, patients may have to pay out-of-pocket for their treatment, which can be extremely costly and unaffordable for many.
The financial burden of cancer treatment in China varies depending on the patient's location and income level. Urban areas, particularly large coastal cities, tend to have more advanced and accessible medical care than remote areas and rural regions. Additionally, high-level hospitals, such as Grade 3 hospitals, offer more advanced treatments but at a higher cost. Patients from wealthy households may have better access to these treatments, while those from lower-income households may struggle to afford even basic cancer care.
The type of cancer and stage of diagnosis can also impact the financial burden on patients. For example, early-stage cancer patients may have higher odds of receiving treatments at multiple hospitals, potentially increasing their medical expenses. Additionally, the cost of treatment for different types of cancer can vary significantly. Non-small cell lung cancer, for example, was found to cost on average $16,955 in the last three months of a patient's life in 2012, equivalent to 57% of the annual household disposable income for an affluent urban household in Eastern China.
The Chinese government has recognized the financial burden of cancer treatment on patients and their families and has taken steps to address this issue. The government has committed to developing three types of social medical insurance and improving financial protection for cancer patients. Additionally, the National Health Insurance Coverage Policy (NHIC) has improved the utilization and affordability of innovative anti-cancer medicines. However, more needs to be done to ensure that cancer treatment is affordable and accessible to all Chinese citizens.
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Government initiatives to help
Cancer is a major health issue in China, with the country having one of the largest numbers of cancer patients in the world. The high cost of cancer treatment has become a significant issue in the area of social security, with many patients having to pay out-of-pocket, resulting in a heavy economic and mental burden on patients and their families.
The Chinese government has implemented several initiatives to help cancer patients and reduce the financial burden of treatment. Here are some key government initiatives:
- Universal Health Care System: China has a universal health care system that comprises basic medical insurance, urban and rural medical assistance, serious illness aid, and critical illness insurance. By the end of 2014, over 95% of the Chinese population was covered by this basic medical insurance. Poor patients with malignant tumors can receive reimbursements, illness insurance compensation, and medical relief through this system.
- National Health Insurance Coverage (NHIC) Policy: The NHIC policy has improved the utilisation and affordability of innovative anti-cancer medicines. However, the availability of these medicines in hospitals remains low, and further supporting policies are needed to promote affordability.
- Centralised Strategic Price Negotiation: In 2017, the Ministry of Human Resources and Social Security initiated centralised strategic price negotiations with pharmaceutical companies to leverage the advantage of "group purchases" in terms of quantity and price. This initiative aims to reduce the financial burden on cancer patients by ensuring fairer pricing.
- Cancer Screening and Early Diagnosis: The Chinese government has initiated targeted cancer screening projects for breast, colorectal, lung, stomach, esophageal, and nasopharyngeal cancers, focusing on high-risk populations. These efforts reflect a broader commitment to enhancing early diagnosis and cancer prevention.
- Healthy China 2030: This long-term healthcare strategy promotes early diagnosis and advocates for healthy lifestyles through awareness campaigns. It aims to achieve health equity and better access to healthcare for all.
- Initiatives for County Hospitals: The Chinese government has implemented initiatives to improve cancer diagnosis and treatment in county hospitals, which often lack the necessary equipment and trained personnel. These initiatives address administrative approval procedures, reimbursement policies, and direct settlement policies for cross-regional medical care.
- National Medication Price-Negotiated Policy (NMPNP): Instituted in 2017, this policy aims to foster a more regulated and affordable pricing system for anticancer medications, alleviating the financial burden on patients.
These initiatives demonstrate the Chinese government's efforts to improve access to healthcare and reduce the financial burden on cancer patients and their families. However, there is still room for improvement, especially in promoting the availability and affordability of innovative medicines and enhancing cancer prevention and early detection.
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Frequently asked questions
The main form of healthcare in China is a universal health care system, which includes basic medical insurance, urban and rural medical assistance, serious illness aids, and critical illness insurance.
Cancer treatment in China is often expensive and difficult to access, especially in rural areas. There is also a lack of awareness and limited treatment options.
The Chinese government has committed to developing three types of social medical insurance and improving financial protection for cancer patients. They have also invested in cancer prevention and early detection initiatives.
Cancer treatment in China can be a significant financial burden for patients and their families, sometimes exceeding the "catastrophic health expenditure" defined by the World Health Organization.
Yes, cancer patients in China may face challenges such as limited access to innovative treatments, long wait times, and inadequate healthcare services.
