Cost analysis of oral cancer treatment in a tertiary care referral center in India.

Jeba Karunya Ramireddy, Daniel Sathiya Sundaram, Rabin K Chacko


Introduction: As much as the number of oral cancer patients is a heavy burden to the health care system in India, so much is the economic burden to the patient and the relatives, especially in India where most do not have any financial cover for their medical expenditure. Objectives: To find out the approximate cost of treatment of oral cancer through various modalities, and calculate the proportion of direct and indirect expenses, and then identify the factors which would increase the indirect expenses so as to come up with recommendations which will reduce the indirect cost there by reducing the financial burden to the patient. Methods: A retrospective observational study was done in a tertiary care center for cancer treatment and the direct cost (medical expense), indirect cost (non-medical expense) incurred by the patients, their economic status and source of fund for payment of the expenses were obtained. Results: The proportion of indirect cost was about 38.72% of the total cost for patients who underwent a single modality treatment with surgery, around 34.73% for a combination treatment with surgery and RT (Radiotherapy), about 79.63% for treatment with conventional Radiotherapy without surgery and about 49.61% for treatment with IMRT (Intensity Modulated Radio Therapy) without surgery. Availability of financial aid or cover is abysmally poor. Rate of discontinuance of treatment is also very high according to this study.  Conclusion: The proportion of indirect cost is very high and the total expenditure can be reduced by approximately 30% by following measures discussed in this article.


Coelho, Ken Russell. 2012. ‘Challenges of the Oral Cancer Burden in India’. Journal of Cancer Epidemiology 2012. doi:10.1155/2012/701932.

DSouza, Neevan DR, NS Murthy, and RY Aras. 2013. ‘Projection of Burden of Cancer Mortality for India, 2011-202’. Asian Pacific Journal of Cancer Prevention 14 (7): 4387–92.

Dsouza, Neevan DR, NS Murthy, and RY Aras. 2013. ‘Projection of Cancer Incident Cases for India -Till 2026’. Asian Pacific Journal of Cancer Prevention 14 (7): 4379–86.

Magrath, Ian, Pierre Bey, Aziza Shad, and Simon Sutcliffe. 2010. ‘Cancer Funding in Developing Countries: The next Health-Care Crisis?’ The Lancet 376 (9755): 1827. doi:10.1016/S0140-6736(10)62168-X.

Nair, Kesavan Sreekantan, Sherin Raj, Vijay Kumar Tiwari, and Lam Khan Piang. 2013. ‘Cost of Treatment for Cancer: Experiences of Patients in Public Hospitals in India’. Asian Pacific Journal of Cancer Prevention 14: 5049–54.

Nandakumar, Ambakumar, Prakash Chandra Gupta, Paleth Gangadharan, Rudrapatna Narayanrao Visweswara, and Donald Maxwell Parkin. 2005. ‘Geographic Pathology Revisited: Development of an Atlas of Cancer in India’. International Journal of Cancer 116 (5): 740–54. doi:10.1002/ijc.21109.

Ramnath Takiar, Deenu Nadayil, and A Nandakumar. 2010. ‘Projections of Number of Cancer Cases in India (2010-2020) by Cancer Groups’. Asian Pacific Journal of Cancer Prevention 11 (4): 1045–49.

Ray, B. 2013. ‘Auditing Costs of Intensive Care in Cancer Patients in India: A New Area Explored’. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine 17 (5): 269–70. doi:10.4103/0972-5229.120315.

Song, Huan, Fang Fang, Unnur Valdimarsdóttir, Donghao Lu, Therese M.-L. Andersson, Christina Hultman, Weimin Ye, et al. 2017. ‘Waiting Time for Cancer Treatment and Mental Health among Patients with Newly Diagnosed Esophageal or Gastric Cancer: A Nationwide Cohort Study’. BMC Cancer 17 (1): 2. doi:10.1186/s12885-016-3013-7.

Subramanian, Sujha, Rengaswamy Sankaranarayanan, Bela Bapat, Thara Somanathan, Gigi Thomas, Babu Mathew, Jissa Vinoda, and Kunnambath Ramadas. 2009. ‘Cost-Effectiveness of Oral Cancer Screening: Results from a Cluster Randomized Controlled Trial in India’. Bulletin of the World Health Organization 87 (3): 200–206. doi:10.2471/BLT.08.053231.

Wani, MohammadAshraf, Sa Tabish, FarooqA Jan, NazirA Khan, Za Wafai, and Kk Pandita. 2013. ‘Cost Analysis of In-Patient Cancer Chemotherapy at a Tertiary Care Hospital’. Journal of Cancer Research and Therapeutics 9 (3): 397. doi:10.4103/0973-1482.119314.


  • There are currently no refbacks.

Copyright (c) 2017 Asian Pacific Journal of Cancer Biology

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.





Asia Pacific Organization for Cancer Prevention 

West Asia Organization for Cancer Prevention