Journal Article

Out-of-pocket cost and financial catastrophe of patients with cancer: the alarming cost-of-illness in Bangladesh

Tran-Duy, An, Islam, Rasedul, Sarker, Abdur Razzaque

2025

Overview

Background Out-of-pocket (OOP) cost of cancer treatment has increased substantially globally. In low- and middle-income countries, many patients face financial distress due to cancer. For patients with cancers in Bangladesh, this study aimed to (1) estimate the annual OOP cost of cancers from households’ perspective, (2) assess the coping strategies and financial distress, and (3) examine factors associated with OOP cost. Methods We used data from a cross-sectional hospital-based survey conducted in three randomly selected hospitals in Bangladesh. A bottom-up micro-costing approach was used to estimate the OOP cost components. We used the logistic regression model and the generalized linear model to examine the determinants of distress financing and OOP cost, respectively. Results The average annual OOP cost per cancer patient was US$ 6,504 (range, US$ 959 − 29,681), which was greater than 2 times the average annual household income. About 90% of households faced distress financing due to cancer. Having at least one comorbid condition, cancer stage 2 or higher, households having no elderly people, or having treatment abroad was significantly associated with a higher OOP cost compared to those without the condition. Conclusion OOP cost of cancer treatment and the proportions of patients with distress financing and financial catastrophe are alarmingly high in Bangladesh. Earlier cancer diagnosis and implementation of Government financial health protection schemes are crucial and urgent to alleviate the enormous economic burden and ensure equitable access to care for the patients.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adaptation, Psychological / Adolescent / Adult / Aged / Analysis / Bangladesh / Cancer / Cancer patients / Cancer therapies / Care and treatment / Chemotherapy / Cost of Illness / Costs / Cross-Sectional Studies / Economic burden / Equality and Human Rights / Female / Financial distress / Financial Stress - economics / Financing / Financing, Personal - statistics & numerical data / Health aspects / Health care expenditures / Health Expenditures - statistics & numerical data / Health Policy / Health Promotion and Disease Prevention / Health Services Research / Hospitals / Households / Humans / Illnesses / Male / Medical care, Cost of / Medical research / Medicine / Medicine & Public Health / Middle Aged / Neoplasms - economics / Neoplasms - therapy / Older people / Out of pocket / Out-of-pocket expenses / Patients / Prevalence studies (Epidemiology) / Public Health / Questionnaires / Regression models / Social Justice / Social Policy / Statistical models / Surveys and Questionnaires