Economies of scale can lower cancer care costs

LOW- and middle-income countries like the Philippines can lower cancer care costs by adopting economies of scale and standardizing care for a specific clinical problem, according to health experts.

There are cost advantages when specialized centers for cancer are used, said Maria Carissa A. Alejandro, chief public health officer at Ayala Healthcare Holdings, Inc.

“You can buy medicines and equipment at a cheaper price,” she told a cancer summit in Filipino on Feb. 24. “Doctors and nurses also get better at what they do, reducing the time it takes them to do their job.”

Clinical pathways, which are patient care algorithms based on the best evidence, are also important because they help reduce unnecessary tests or medicines.

Using more generic drugs will also encourage patients to complete an otherwise expensive treatment.

A study on cancer patients in the Association of Southeast Asian Nations found that 48% had experienced a financial catastrophe a year after their diagnosis. A further 29% died within 12 months after they found out they had cancer.

In the Philippines, cancer is the third leading cause of death.

“Many get diagnosed with cancer at a late stage,” Ms. Alejandro said. “That is the reality in the Philippines and other low- and middle-income countries.”

She cited ways for healthcare providers to lower the cost of cancer care.

For one, bundling payments for breast cancer treatment had led to 34% in patient savings for United Healthcare, a private healthcare and insurance company in the US.

Bundled payments, which cover most or all of the services involved to treat a patient’s medical condition, is said to be the middle ground between traditional fee-for-service payments that entail little financial risk for providers and full capitation, where a provider assumes almost full financial risk.

Introducing a doctor’s compensation scheme that combines fee-for-service with a variable component based on performance metrics might also work, Ms. Alejandro said.

Many of the bigger changes in cancer care started as a proof of concept, she told the cancer summit.

“Somebody [acted on] an idea… which eventually led to broader policy and systemic changes.” — Patricia B. Mirasol