Cost-Description of Cancer Patients In Indonesia: A Systematic Review

Yogi Pasca Pratama1), Ratna Dewi Kumalasari2), Anang Pra Yogi3)


1)Faculty of Economy and Business, Universitas Sebelas Maret

2)Masters Program in Public Health, Universitas Sebelas Maret

3)Masters Program in Economy and Development Study, Universitas Sebelas Maret



Background: The financial costs of cancer are high. In Indonesia, the government has launched the National Health Insurance (NHI) since 2004. However, due to the limited health insurance coverage and other barriers to health care, many Indonesians are not able to obtain optimal health care. The purpose of this study was to systematically review the cost-description of cancer patients in Indonesia.

Subjects and Method: This was a systematic review. Research question was formulated to guide the process of searching and extracting selected articles. The research question was formulated in PICOC format: (1) Population, (2) Intervention, (3) Comparison, (4) Outcome, and (5) Context.

Results: ASEAN Cost in Oncology (ACTION) studies in 8 countries (Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand, and Vietnam), in 2012-2014, reported that 78% of cancer patients become poor and lead to death. In 2014, as many as 702,207 cancer patients were Indonesian people with NHI enrolment. The prevalence of cancer increased to 1,257,230 cases in 2015 and 1,308,061 cases in 2016. The managing body of social insurance in health (BPJS Kesehatan) spent Rp1.5 trillion in 2014 to cover medical expenses for BPJS participants with cancer. The cost of cancer care continued to rise to Rp 2.2 trillion in 2015 and Rp 2.3 trillion in 2016. Cancer was the third highest of health expenditure incurred by BPJS in 2015 and 2016. The government defined fees for BPJS but the contribution paid by the government was low. Recipients of contribution assistance received 0.2% of the Gross Domestic Product (GDP) or around 1.2% of the State Budget. However, other countries allocate ≥4% of GDP for health financing. Indonesian government and the NHI only funded 1.1% of GDP for cancer financing.

Conclusion: Cancer-related medical expenditures have become a burden in the NHI budget. The NHI has not met the need of cancer treatment cost.

Keywords: cancer, health cost, National Health Insurance

Correspondence:  Yogi Pasca Pratama. Faculty of Economics and Business, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: (+62)81334401515.


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