In its first year, the Pradhan Mantri Jan Arogya Yojana (PMJAY), the tertiary care arm of Ayushman Bharat, has funded the treatment of 90,000 cancer patients through 1.8 lakh hospital admissions.
This is according to data available with the Union Health Ministry, which also show that every year there are 11.57 lakh new cancer patients in India and 7.84 lakh cancer deaths. At any given point, there are 22.5 lakh Indians living with cancer.
Tamil Nadu, with 40,056 cases, tops the state where the most cancer patients availed treatment under PMJAY, followed by Kerala (22,000), Madhya Pradesh (19,455), Chhattisgarh (15,997) and Gujarat (14,380).
Officials say the figures reflect not just cancer incidence in these states but also the availability of treatment facilities and how well PMJAY is performing in these states. The cancer care claims under PMJAY show a steep rise over the past year. In September 2018 — the scheme was launched on the 23rd of that month — there were just 906 hospitalisation claims across the country for cancer. In September 2019, the figure was 87,382.
The National Health Authority (NHA) has so far sanctioned Rs 321 crore for cancer care. Of the total cancer packages claimed, 30,376 are for cancer of the reproductive system such as the cervix, ovary, testes etc. 28,506 breast cancer packages have been claimed while PMJAY has funded treatment of 21,379 GI cancer cases and 14,639 of blood and blood vessels. NHA officials say these figures are in line with cancer incidence in the country.
“A large number of cancer cases go untreated every year, especially among the poor. We need a clear strategy for early detection and provision of affordable and quality cancer care. One major challenge is to increase the availability of quality cancer care facilities across the country, especially in the northern states,” said Dr Indu Bhushan, NHA CEO.
The NHA is responsible for the implementation of PMJAY under which 10.74 crore families will be entitled to an annual health cover of Rs 5 lakh per family. Until now, of the intended 50 crore beneficiaries, over 10 crore e-cards have been issued.
That India has large unmet cancer treatment facilities is fairly well known and with many reaching hospitals at an advanced stage, which makes treatment unaffordable, only adds to the cancer mortality figures.
To address this, under Ayushman Bharat, at the health and wellness centres (HWC), screening has started for three types of cancer – oral, cervical and breast. Health Ministry officials say that until August 2019, of the 76 lakh screened for oral cavity cancer, 10,218 people are being treated. More than 53 lakh women were screened for breast cancer and around 9,700 women are on treatment. More than 37 lakh women have been screened for cervical cancer and around 10,000 are on treatment.
“As HWCs become operational, a significantly large number of cancer cases will be detected. In addition, with PMJAY getting mainstreamed, demand for treatment including cancer will expand. We should witness a huge increase in the number of cancer treatments especially among the poor, in the years to come. The irony is that prevention will increase the treatment burden in the short run,” said Bhushan.
More than 1,000 hospitals are empanelled with the NHA for cancer care. Radiation oncology packages are the third-most claimed under tertiary care packages and medical oncology is the sixth-most claimed, show NHA data. The other top tertiary care packages are for cardiovascular diseases, orthopaedics and urology.
Incidentally, the data also show that against overall scheme portability of just 1% (patients from one state availing treatment in another), for cancer the figure is in the 7% range. This means many more people are travelling away from their home states for cancer than for other diseases.