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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1815734
Review Article

Economic Burden of Pediatric Oncology Care in Developing Countries: A Systematic Review

Authors

  • Sri Mulatsih 

    1   Division of Hemato-Oncology, Department of Child Health, Dr. Sardjito General Hospital, Yogyakarta, Indonesia

  • Clements Nicodhemus Garuda Nagara

    2   PDHI Yogyakarta Islamic Hospital, Yogyakarta, Indonesia

  • Barlaam Bagus Purwaka

    3   Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia

  • Devanya Tiara Kirani

    3   Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia

  • Felicia Dara Puspitaning Pandita

    3   Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia

  • Devie Kristiani

    4   Division of Hemato-Oncology, Department of Child Health, Bethesda Hospital, Yogyakarta, Indonesia

Funding None.
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Abstract

Introduction

Pediatric oncology care in developing countries poses considerable economic challenges due to high direct medical, direct nonmedical, and indirect costs related to childhood cancer treatment. Families often face catastrophic financial burdens, which impact treatment adherence and outcomes.

Objectives

This article summarizes and analyzes the economic burden of pediatric oncology care on families and health systems in developing countries.

Materials and Methods

A systematic review of studies from low- and middle-income countries was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing six major databases (PubMed, ScienceDirect, Cochrane Library, Lippincott Home, Sage Journals, and Google Scholar) to identify relevant studies published from 2015 until 2025. The Population, Intervention, Comparison, and Outcomes (PICO) framework was applied alongside specific keywords to select studies relevant to the research topic.

Results

Findings show that families bear substantial out-of-pocket expenses, including treatment, transportation, accommodation, and lost income, often exceeding their financial capacity. Health financing systems are often inadequate, leading to high treatment abandonment rates. Access to insurance and financial support programs reduces economic hardship and improved treatment continuity. Cost-effectiveness analyses demonstrate that investing in pediatric oncology care yields substantial health and economic benefits, with the cost per disability-adjusted life year averted typically falling below one times the country's gross domestic product per capita.

Conclusion

The economic burden of pediatric oncology care in developing countries is profound and multidimensional, necessitating strengthened health financing, expanded insurance coverage, and social support programs to improve access and reduce financial toxicity for affected families.

Keywords

economic burden - pediatric oncology care - developing countries - children - health systems

Data Availability Statement

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


Authors' Contributions

S.M. contributed in conceptualization, methodology review, offered critical revisions, supervised the manuscript, secured funding, contributed to discussion and result interpretation, provided project oversight, and also provided final approval of the manuscript. C.N. contributed in methodology review, offered critical revisions, supervised the manuscript, secured funding, provided project oversight, contributed to discussion, and result interpretation. B.B. contributed in conceptualization, study design, collected and analyzed data, created tables, drafted the manuscript, and contributed to discussion and result interpretation. D.T. and F.D. contributed in study design, reviewed methodology, analyzed data, and contributed to discussion and result interpretation. D.K. contributed in methodology review, discussion, and data organization.


Patient Consent

Patient consent is not applicable as this study is a systematic review of published literature and does not involve primary patient data.




Publication History

Article published online:
20 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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