NEW DELHI :
With over 4.70 lakh cancer cases treated under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana so far, the government is now looking at specialised screening services for cancer in health and wellness centres under the scheme.
As on 15 December, 2019 a total of 470,133 cancer cases have been treated under AB-PMJAY, according to the latest data available with National Health Authority (NHA), nodal agency for implementing the scheme. The number of cases treated under the medical oncology was 3,59,327, paediatric oncology was 17,421, radiation oncology was 76,444 and surgical oncology was 16,941, as per the NHA data.
“Oncology has been one of the most used tertiary specialities in PMJAY so far. However, we are reaching only a fraction of actual cases. Lack of knowledge, screening and cancer-care services have impeded the progress. With Health and Wellness Centres screening for major cancers, we should be able to treat more cases and should be able to get them early," said Indu Bhushan, Chief Executive Officer (CEO) of AB – PMJAY and NHA.
Ministry of health and family welfare is also exploring options to provide quality diagnostic services from certified laboratories for screening of diseases to beneficiaries of the scheme under a Public Private Partnership (PPP) model.
According to a working paper from NHA titled--early trends from Utilization of Oncology services: insights from AB-PMJAY-- Oncology comprised nine percent of claims submitted, and 34% of all tertiary claims submitted till July 2019 since September 2018 (the scheme’s launch) across 26 States and union territories. Two States (Tamil Nadu and Maharashtra) generated 60% of all Oncology claims in the said period.
“Noticeably, females are accounting for higher number of claims submission in all the age-categories as compared to men, highest in the age group of 45-50 years. Ovary, Breast, Cervix and Radical hysterectomy are some of the common cancer types among females; and Terminally Ill palliative, Colon Rectum and head and neck cancers are among males for which maximum claims are generated during the period," the working paper stated.
An estimated 2.25 million people in India live with cancer as of March 2018, according to the National Institute of Cancer Prevention and Research (NICPR). More than 1,157,294 new cancer patients are registered every year. In 2018, 413,519 men and 371,302 women died of cancer, according to the Indian Council of Medical Research (ICMR). That apart, 9.81% of men and 9.42% of women are at risk of developing cancer before 75 years of age.
AB-PMJAY is the flagship scheme of Narendra Modi government also dubbed as Modicare and is detailed as the world’s largest fully government-financed health insurance scheme. As a considerable number of patients of various diseases including cancer don't have access to treatment either due to lack of finances or healthcare services, PM-JAY aims to reduce catastrophic expenditure for hospitalizations, and help mitigate the financial risk arising out of catastrophic health episodes, the government claims. As per the scheme, entitled families can use the quality health services they need without facing financial hardships.
The scheme provides a cover of up to Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalization to over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries). PM-JAY provides cashless and paperless access to services for the beneficiary at the point of service.
To improve cancer screening and treatment, the NHA and National Cancer Grid (NCG), a government initiative to create a network of cancer centres, research institutes, patient groups and charitable institutions across India, recently signed a memorandum of understanding (MoU) to develop uniform standards of patient care to battle cancer under AB-PMJAY.
NHA and NCG will jointly review existing cancer treatment packages, pricing of services, standard treatment workflows covered under AB-PMJAY and plug in necessary gaps to ensure enhanced quality of cancer care. Both organisations will work on creating cancer services/package benefits based on priority setting tenets such as evidence of efficacy, value (cost-effectiveness), low harm, demand/ burden, medical necessity, and wide availability.