CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2022; 43(03): 285-288
DOI: 10.1055/s-0042-1748798
Perspective

Access, Affordability, and Sustainability: Barriers to High-Quality Care in a High-Income Country

1   Department of Radiation Oncology, University of Mississippi, Mississippi, United States
,
Aju Mathew
2   Department of Oncology, Malankara Orthodox Syrian Church Medical College Kolenchery, Kochi, Kerala, India
› Author Affiliations
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Introduction

There is a perception among oncologists that the field of global oncology pertains only to matters related to low- and middle-income countries (LMICs). It stems from a perception that considers lack of access to cancer care and unaffordability of therapy as problems that plague the less affluent regions of the world. In this commentary, we aim to shed light on the fact that these issues do not respect the dichotomies of high-income versus low-income countries or the global north versus south.

When physicians from high-income countries were surveyed about the access to cancer medicines deemed essential by the World Health Organization, a large majority of them felt that these medicines, including immunotherapy, were universally accessible (i.e., no substantial out-of-pocket expense for >90% of patients).[1] Unfortunately, the inaccessibility and unaffordability of cancer care are profound even in high-income countries, although we perceive it as otherwise. This inaccurate fact stated by practicing oncologists makes it clear that their current understanding of the accessibility and affordability of cancer care as oncologists is faulty.

Almost 27 million (8.6%) Americans were still uninsured in 2016.[2] A large proportion of cancer survivors experience financial hardships due to cancer.[3] Even if we falsely assume that the out-of-pocket expense for the individual is marginal, the economic burden of cancer care is steadily rising. It is definitely not sustainable for the economy in the long run.



Publication History

Article published online:
02 July 2022

© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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