Economic burden of breast cancer to the households in Punjab, India

Abstract

Introduction: Breast cancer is on rise and cervix cancer is on declining mode according to the cancer registry data in India. The major mode of financing treatment is out-of-pocket (OOP) and this can push 25% of the cancer affected households below the poverty line. Materials and Methods: A cross-sectional descriptive study with a household perspective was done in the state of Punjab. By using probability proportional to the size method and systematic random sampling, the sample was drawn from every district of Punjab. A face-to-face semi-structured interview schedule was administered to 221 patients. Results: The direct cost contributed 79% toward the total cost-of-illness. The cost of drugs (36.23%) followed by cost of hospitalization (27.05%) and productivity loss (13.44%) were the main contributors toward the total cost of illness. The contribution of indirect cost is 21 per cent of the total cost. The cost of treatment depends upon type of facility used (more in private as compared to the public), stage of cancer (stage above first stage cost more than the first stage), and age at the time of diagnosis aged above sixty incurred more expenditure as compared to the aged below sixty. The 84% of the households had experienced the catastrophic health expenditure (CHE) and 51% of the households had faced distress financing (DF). The main financial coping strategies*(*multiple strategies) used were saving (74%), borrowing at low rate of interest (88%), social nets (55%), and selling financial assets (30%). Key