The ‘hidden costs’ of chemotherapy

play article
Subscribers can listen to this article
  • The cost of chemotherapy treatment is high
  • There are also non-medical costs involved in cancer treatment 
  • According to a recent study, these costs can weigh heavily on chemotherapy patients

In South Africa, the cost of cancer treatment is very high, and a study conducted in 2020 to estimate the cost of chemotherapy in the public sector arrived at a whopping R15 774 as the average care cost per patient. This was per "episode of care" at Groote Schuur Hospital for breast cancer.

Although the high cost of cancer treatment tends to be the focal point of many research papers, there are other non-medical costs that also need to be taken into consideration. A new study by the University of East Anglia (UAE) was the first to investigate non-healthcare costs when undergoing chemotherapy.

Calculating the true cost

Researcher at UEA's Norwich Medical School, Professor Richard Fordham explains, “As well as the cost of the treatment itself, there are many societal and personal costs associated with chemotherapy. These might include taking time off work, paying for hospital transport or parking, paying for over-the-counter medications or dietary supplements, the cost of wigs, headscarves and new bras, and the cost of informal care.”

“But until now it has not been known what the total cost of all of this really is. We wanted to find out what the true total cost of chemotherapy is for patients, caregivers and wider society, for treating breast cancer in the UK.”

The researchers arrived at an average of £1 100 (around R20 350.84) in annual out-of-pocket costs per patient, excluding the cost of the emotional wellbeing of carers, which would require additional funds. 

In order to calculate these costs, the researchers collected information from patient surveys, clinical registries, clinical guidelines, and also in the form of semi-structured interviews with patients and medical staff in order to get their views. 

‘Patients talk about their worlds falling apart’

Dr Stephanie Howard-Wilsher from UEA’s Norwich Medical School said that the interviews helped the research team better understand the impact of non-medical costs on patients.

“The interviews with patients really show the impact that breast cancer has on lives. They talk about their worlds just falling apart, and chemotherapy side effects like hair loss, tiredness, constipation and diarrhoea, loss of taste. And they also talk about the emotional impact for their families and those caring for them.”

South African context

Out-of-pocket costs for cancer patients in South Africa are also considerable, especially in the light of the high unemployment rate. Out-of-pocket expenses include the following:

  • Wigs: According to PriceCheck, wig prices range from R250 to R5 000.
  • Food: Cancer patients may need to eat special foods, and according to a study, most South Africans cannot afford this.
  • Fuel or transportation cost to medical facilities: This depends on distance and mode.
  • Mental health support: Therapy appointments can cost anything from R600 upward).
  • General household expenses: These may increase with patients spending more time at home.

Researcher Anna Sweeting from UAE, who was also part of the research team, concluded: “Our work shows how chemotherapy carries significant and far-reaching indirect costs for society, as well as for patients and their carers – beyond the costs associated with the treatment itself.”

Image credit: 

We live in a world where facts and fiction get blurred
In times of uncertainty you need journalism you can trust. For 14 free days, you can have access to a world of in-depth analyses, investigative journalism, top opinions and a range of features. Journalism strengthens democracy. Invest in the future today. Thereafter you will be billed R75 per month. You can cancel anytime and if you cancel within 14 days you won't be billed. 
Subscribe to News24
Show Comments ()
Editorial feedback and complaints

Contact the public editor with feedback for our journalists, complaints, queries or suggestions about articles on News24.