The direct costs of treating and managing haematological cancers at a tertiary hospital: Payer’s perspective

Background Haematological cancers require extensive treatment, which can cause a significant financial burden on the funder and provider of care. The incidence of haematological cancers is increasing in South Africa due to the rise in HIV/AIDS cases, and as cancer incidence rises, so do treatment costs. There is limited knowledge of the direct costs of managing these cancers in the public health care system in South Africa. This study aimed to determine the direct costs associated with the treatment and management of haematological cancers in a tertiary public sector hospital. Methods A descriptive retrospective study was conducted using the data files and medical records of patients treated in the haematology unit 12 months prior to data collection. Using an adapted data collection instrument and a ' time-motion ' method, a micro-costing method was utilised to establish direct medical costs determined from the provider's perspective. The sum of all costs was used to establish the average total cost of care per haematological patient. Results The results are presented as an average per patient with 53 patient files that met the inclusion criteria. Hodgkin’s lymphoma had the highest patient count, accounting for 19 (36%) of the total sample. The average total cost of treatment and management of haematological cancer per patient was R 126385,62 per year, and the average cost of chemotherapy per cycle per patient was R25600,23. The major cost drivers were chemotherapeutic agents, with non-Hodgkin’s lymphoma having the highest average cost and the ABVD regimen being the most prominent. Conclusions A comprehensive quantification of the direct costs of treating and managing haematological cancers was determined. Understanding the costs associated with these cancers will allow public healthcare funders to make effective financial decisions and adequate treatment plans.