Just like other diseases, cancer can be cured if detected early and treated effectively. The cost of treatment varies based on the treatment type but they are still very expensive and out of reach for an average Nigerian.
Chemotherapy, a required treatment for cancer especially at advanced stages, costs between N600,000 to N1.5 million per session. The cost varies depending on the type of cancer and breast and cervical cancer are some of the most expensive to treat. Breast cancer is the most prevalent cancer in Nigeria. Radiotherapy, sometimes combined with chemotherapy for cancer treatment, costs about N600,000 for all sessions again this is subject to the type of cancer being treated. Aside from these therapies, cancer drugs are also expensive costing as much as N300,000 per month.
A report puts initial cervical cancer treatment cost between $4,000 to $6,000. When these figures are put together, on the average, a cancer patient in Nigeria will most likely need at least N2.4 million to receive comprehensive care. It is important to note that treatment of cancer is often continuous.
Clearly, cancer care, unlike other kinds of malaise, costs far too much for it to be out of pocket. Yet, most Nigerians pay for healthcare costs out of pocket with only 3% of the population covered by health insurance. This is likely connected to the high fatality rate of the disease in Nigeria, averagely 72,000 Nigerians lose their lives to cancer annually.
Can Health Insurance Help Pay for Cancer Care?
For the 3% of Nigerians covered by insurance, are they still able to afford cancer care? Unfortunately, health insurance providers in Nigeria don’t provide comprehensive care for cancer patients. Although most Health Management Organisations (HMOs) list cancer care as part of the benefits of their insurance cover, this cover is limited across all tiers of insurance coverage from the least to the highest.
Reliance HMO
Reliance HMO offers four distinct plans in their health packages. These are the Red Beryl Plan, Alexandrite Plan, Diamond Plan, and the Red Diamond Plan.
The above mentioned plans provide partial insurance coverage for cancer treatment but with different maximum limits.
The least which is the Red Beryl Plan has a maximum cover of N250,000 for any subscriber who is diagnosed with cancer.
Those under the Alexandrite Plan enjoy a maximum of N400,000 for cancer treatment. Diamond Plan subscribers have a coverage of N750,000, and the Red Diamond Plan subscribers have a N1 million limit of paid expenses.
Hygeia HMO
The Hygeia HMO has three plans – the individual and family; SME and Corporate plans. The three plans have different categories. However, only the Corporate plan covers cancer care.
Under the corporate plan, there is HyLite, HyBrid, HyValue, HyEnhanced and HyLeague, all of which cover cancer care.
The HyLite cancer care plan is fixed at N300,000. It covers Oncology tests, Drugs plus Chemotherapy and Radiotherapy.
A global refundable limit applies to the HyLite plan. A global refundable limit refers to the amount that will be refunded by Hygeia HMO if at any point the enrollee/subscriber chooses to access the cancer care outside of Nigeria.
The cancer care for HyBrid and HyValue is also N300,000 but with no details of a global refundable limit unlike the HyLite.
For the HyEnhanced and HyLeague, the price is pegged at N1,000,000 and N2,000,000, respectively.
Random sampling of some 59 HMOs shows that most of them don’t cover cancer care. And some of them that offer cancer care did not give a detailed breakdown as the other two mentioned above.
Most of the HMOs in Nigeria that offer cancer care have a maximum limit of N1 million for cancer care with the exception of the Hygeia HMO whose highest plan offers a N2 million maximum limit.
The Nigeria Health Insurance Scheme (NHIS) provides far less for cancer treatments, covering a few lab tests and drugs that users consider insignificant to the overall care need.
Even with coverage of up to N2,000,000, accessible only at the highest tiers of coverage provided by Health Management Organisations, it is still insufficient for comprehensive cancer care.
How do people pay for cancer treatments? Borrowing and public appeals. It is little wonder a cancer diagnosis is perceived as a death sentence in Nigeria.
Nigeria in 2018, launched a $250 million National Cancer Control Plan for 2018-2022 and its primary goal is reducing cancer prevalence and mortality rates.
The plan reads in part “to increase the number of comprehensive cancer care centres in the country that can offer radiotherapy as part of treatment for cancer patients.” Part of the idea is to have a national screening starting from a pilot of national breast screening.
In 2022, not only is this plan not widely known, it is unclear if any advancements have been made towards the achievement of the goals and if there has been any impact on cancer prevention and care in the country.
In 2019, a Chemotherapy Access Treatment Programme was launched to provide cost mitigation for chemotherapy treatments and cancer drugs. Again, post its launch it is unclear how many Nigerians have benefitted from this programme.
The state of the health sector which includes poor infrastructure and increasingly scarce personnel might be a critical factor in the treatment of cancer.
For instance, there are only three public radiotherapy centres in Nigeria, Lagos, Enugu and Abuja. The global standard is for 1 Centre to a population of 250,000, clearly that is not the case. Nigeria had 124,815 new cases in 2020 alone and only three public radiotherapy centres to care for this burden. Patients are left to approach private centres with high costs.
There are 90 oncologists to 10000 patients in Nigeria which is far from WHO recommendation of 1 oncologist to 600 patients. Brain drain in Nigeria is not new and the health sector has always been a target for skills “exports”. However in recent years there has been an uptake in reported exodus of doctors from the country, a situation that is ironically underscored by sovereign countries holding recruitment exercises for local doctors in the country. Poor welfare, owed salaries, insufficient tools of work are some of the reasons doctors are leaving the country.
Cancer cases continue to rise alarmingly in the country and there needs to be a holistic strategy which would necessarily include increased funding to the health sector to begin to slow mortality rates due to cancer.