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The Good News about Cancer Treatment in South Africa

Monday, February 09, 2015

There have been many developments in the field of cancer research and medicine technology – resulting in higher cure rates, but also in more expensive cancer treatments.

Four years ago, Cape Town pensioner Emmerentia du Plessis, 68, was diagnosed with breast cancer. Although her diagnosis was fairly straight-forward – she did not need any chemotherapy or radiation – she needed to have surgery in the form of a mastectomy (removal of one breast).

As she wanted an immediate reconstruction, she needed to make a co-payment and ultimately selected a plastic surgeon who charged far in excess of medical aid rates, which resulted in Emmerentia paying close to R30 000 out of her own pocket. This is the reality that 14 million people worldwide face every year when they are diagnosed with cancer – not only the emotional and psychological consequences of a cancer diagnosis, but the financial implications as well.

In South Africa, one out of four people will be affected by cancer, either directly or indirectly, through a family member or friend or being diagnosed themselves, says a spokesman for the Cancer Association of South Africa (Cansa).

But with World Cancer Day taking place on 4 February 2015, the good news is that not only is the disease preventable, but also – through better treatment – more and more people are surviving it. According to the National Breast Cancer Foundation, which is based in America, when breast cancer is caught early and treated at Stage 1, the five-year survival rates are about 98%.

But better treatment comes at a high cost. Dr Ernst Marais, Operations Executive at the Independent Clinical Oncology Network (ICON) says that the rising cost of cancer treatment is a major international concern and South Africa is no exception.

“Depending on the kind of cancer and the complexity of a case, treatment per year can cost less than R10 000, or way over R1 million,” says Dr Marais. He says ensuring that more South Africans have access to quality cancer care at a reasonable cost is one of the core principles of ICON, a network of oncology specialists, committed to widening access to quality cancer care across South Africa.

The network is already working with most of the major South African medical aid schemes and administrators, providing the highest quality cancer care for scheme members and significantly reducing the administrative burden for both practices and funders.

Since it was founded eight years ago, ICON has made its presence felt by reducing the cost of cancer treatment. Increasing the utilisation of appropriate generic cancer drugs has been one of ICON’s missions and the benefits are there for non-medical aid members as well – resulting in better – and more cost-effective treatments for all cancer patients in South Africa. The impact of the ICON formulary has been significant – over the last few years, the prices of generic medicines have reduced significantly – some classes of chemotherapy drugs dropping in cost by as much as 400%.

ICON has also helped to reduce costs by drawing up treatment protocols, which are scientifically validated and simplify the treatment decision-making for doctors and patients – ensuring that the right treatment is given to the right patient. Dr Marais says that the philosophy is that the patient, not the funder or even the doctor, should be at the centre of the process.

“For us at ICON, equity of care is extremely important and it goes to the core of what we do. So to be clear, it is not about saving money, which implies cutting corners, but about more efficient and better cancer care, ensuring good outcomes and reasonable prices.” He adds, “It is always outcomes over cost.”

For Emmerentia, the outcome has been very positive, despite the extra cost. “I had the best doctors in the world,” she says. “That R30 000 came as a bit of a shock back then, but I don’t regret paying it one bit,” she says as she celebrates another year of being cancer-free and in remission.

Article published in The ICON Newsletter January 2015

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