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We need to bring cancer care costs down, and soon

A monthly course of chemotherapy in the UAE can cost up to Dh32,000 depending on type of the cancer.

Cancer is a broad term - it encompasses a group of over 100 different diseases causing uncontrolled cell growth leading to complications and death. According to the World Health Organization (WHO), cancer incidences in the Middle East including in the United Arab Emirates (UAE) are on the rise, with the number of cases expected to double by 2030.
In the UAE alone, approximately 12 new cases are diagnosed every day and 4,500 new cases of cancer are currently diagnosed per year. Breast, colorectal and lung cancers are more common, according to a report released by the Department of Health Abu Dhabi. Cancer claims 78 deaths per 100,000 people in the region based on figures provided by WHO. This report also states that cancer is the third leading cause of deaths in Abu Dhabi, signifying the large scale of this problem. This regional rise in cancer cases can be attributed to unhealthy lifestyle choices, lack of awareness, access to quality treatment and late detection. In many cases, patients tend to seek treatment abroad with the hope of better recovery. As such, there is a pressing need to take action in order to combat cancer locally and reverse this trend.
According to the UAE National Health Agenda 2021 key performance indicators, the target for 2021 is to reduce the cancer mortality rate by 18 per cent to a maximum of 64.2 deaths per 100,000 people. The National Health Agenda 2021 requires cooperation on a countrywide and regional level from governing bodies and healthcare providers, with the aim of reducing the burden of cancer while improving the local medical systems readiness and responsiveness. This ambitious target can only be met if resources are leveraged to enable a proper strategy for affordable, accessible, high-quality healthcare including preventative screening, sustainable financing, high-quality treatment protocols and standard palliative care.
Treating such a complex disease in any region comes with its own challenges. Perhaps the most critical among this is delayed diagnosis. Laboratory tests and radiology imaging techniques are proving increasingly promising to detect and discriminate benign and aggressive tumours. Early detection increases the chance of successful treatment, while delays in accessing cancer care correlate with late-stage presentation and lowers the likelihood of survival.
The next challenge associated with detection of cancer is the cost. While in Dubai, some of the tests and basic treatment of cancers like breast, cervical and colorectal are now being covered under the basic insurance plan, a lot still remains to be done. Many people still lack access to cancer detection methods if they are from lower socioeconomic backgrounds or do not have health insurance. This automatically puts these individuals at a disadvantage and implicates a higher rate of morbidity and mortality.
Subsidised cancer screening programmes offered by some healthcare providers in the UAE is a major step towards achieving the National Agenda 2021 target. Access to affordable screening is imperative and regular screenings allow doctors to detect cancer at an early stage, which improves the treatment outcome and makes the disease easier to treat.
If or when diagnosed, patients then face an enormous financial burden of cancer treatment. Recent advances in cancer biology have led to therapies that are positively impacting cancer survival rates. Established treatments can include a combination of surgery, chemotherapy and radiation therapy, combined with novel therapies such as immunotherapy, hormone therapy and targeted therapy. Although some of these treatments and agents have been associated with enormous benefits, many come at a substantial cost.
According to cancer charity Rahma, a monthly course of chemotherapy in the UAE can cost up to Dh32,000 depending on type of cancer and treatment. This means much of the available cancer care in the region is unaffordable and inaccessible to patients.
Moreover, many insurance companies do not cover patients with pre-existing disease such as cancer meaning they simply cannot opt for expensive treatment.
The Affordable Care Act passed in 2010 in the US contained a number of provisions to influence patient access to cancer care and increase health insurance coverage. As a result, 16.4 million citizens who were previously uninsured in the US were covered by insurance by May 2015. In India the reduction of prices of chemotherapy drugs in 2016 helped in many more patients seeking treatment. These schemes prove that the government has the primary responsibility in the regulation of cancer treatment prices where they must provide guidance to pharmaceutical manufacturers, insurers and healthcare providers. There must also be a transparency in costs related to patients, whether it is subsidised, incentivised or covered by health insurance.
Access to affordable healthcare is the centrepiece in the fight against cancer.
Dr Azad Moopen is the Founder Chairman and Managing Director of Aster DM Healthcare