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The expensive battle for a cure, how can the economic burden be removed for patients in treatment?

2023-12-24 08:50:36Biznes SHKRUAR NGA REDAKSIA VOX

The expensive battle for a cure, how can the economic burden be removed for

In the battle with a disease, the challenges that appear are further costs, even if the health system provides free treatment. Tumors are the third cause of death in Albania, how can the economic burden be removed for patients undergoing treatment?

In today's world, the treatment of tumors is a great challenge, not only for patients and their families, but also for health systems and society in general. Tumors, in most cases, require a combination of specialized medical services such as surgery, radiotherapy and medical therapy.

Tumor treatment is usually associated with high costs, including tests, ongoing medical care, expensive drugs, and the cost of patient follow-up after treatment. The cost of cancer treatment depends on many factors, including the type of tumor, its stage, the method of treatment used and the geographic location. Often, patients are forced to face high costs, even though many countries have different programs to cover the treatment of tumors.

Dr. Euglent Hoxha, onco-obstetrician/gynecologist says that during a year, around 100 young women are diagnosed with cancer of the uterus, cervix and ovaries in the country. But according to the publications of the Ministry of Health, for the annual report of 2021, the cervical cancer screening service was covered for 14,000 women, while the breast cancer screening service was covered for 5,000 women.

In Albania, the health system faces numerous challenges and oncology care is no exception. According to the law, health services are covered by the state, including the treatment of cancer patients. However, there are times when medicines may be insufficient or missing. In practice, this can cause delays in treating patients. There may be times when families have to buy medicine or meet other costs associated with treatment. This is a real challenge for many families and there are organizations and charities that can offer help in these cases. But are they enough?

If a patient needs expensive or rare drugs, there are times when the doctor may try to find alternative solutions or coordinate with health authorities to cover the cost. However, this is not always possible. "Experience can vary from case to case, and this is a complex situation that requires individual care and personalized solutions. In general, the lack of medicine is a serious and essential problem that requires real coordination between the doctor, health institutions and organizations that can provide help in such situations", says oncologist Dr. Helidon Nina, who adds that the situation has improved over the years in the Oncology Service at QSUT.

FIGURES

Globally, according to GLOBOCAN 2020 data, there are about 19.3 million new cases of cancer per year and about 10 million deaths from this disease. It is predicted that the number of deaths from cancer will double in the next 20-40 years, with the highest number in low- and middle-income countries. Globally, more than 70% of cancer deaths occur in low- and middle-income countries, where opportunities for prevention, early diagnosis and treatment are limited. In Albania, according to GLOBOCAN 2020 (last updated data), 7037 new cases of cancer for 2020 and 3978 deaths were registered.

According to the statistics for 2022 from INSTAT, 3,233 people lost their lives not being able to win the battle against the tumor. The official INSTAT figures show that those who did not make it through this serious disease are otherwise 13.5% of the population, a calculation k that ranks tumors in the third largest group of causes of death. The situation has worsened in this context, given that only a year ago, this cause of death was the fourth in the total group of causes. In the 'Tumors' group, the highest percentage is occupied by the subgroup of 'malignant tumors of the digestive system', with 35.2% and 'malignant tumors of the respiratory system' with 23.7%," - it is written in the INSTAT report .

"The percentage of deaths for the group-disease 'Tumor' is 15.7% deaths for men and 10.8% deaths for women", says the publication of INSTAT. Meanwhile, according to the Ministry of Health and Social Protection, 1 in 8 women are diagnosed with breast cancer. The statistics also show that approximately half of the loss of life belongs to the 65-79 age group (47.6%).

A war that requires a lot of money

Matilda Dollani is known by the people around her as "Pink Ray". And not just for her social media page to raise awareness of cancer among women, but because, in itself, there is a ray of light in what Matilda stands for.

In battle still with an illness, unfortunately, incurable but with the inner strength to continue this fight, even though there are physical, psychological, social and financial difficulties.

"When I started to face this situation myself, I thought that people need more information, that family members also need to understand the patient a little better, because it often happens that you can't find the words to explain what you it's passing

Therefore, I decided to open the Instagram profile, 'Pink Ray' to be as close as possible to girls in the same situation. My mother and I have fought together in this battle and I wanted to express all the journey we have, in order to raise awareness" - says Mrs. Dollan.

Her battle continues, although stage IV is considered incurable.

It shows that nowadays there is a determined effort to develop new drugs and therapies, in an effort to make this disease considered a chronic condition and have a prolonged life expectancy.

"The biggest difficulty, in my opinion, is the acceptance of the fact that we are all miserable, we are all scattered in this world as transients. For this, it takes a distribution and time to accept it. It's not that simple.

However, no one knows his fate. No one knows how long it will be. Some people leave this world very young, very young, while others are very lucky and live to be 'old'. All that remains in our hand is to accept life as it is, with the good and the bad, and learn to navigate towards the future", says Mrs. Dollan.

Matilda says that this disease is accompanied by other difficulties, physical, psychological, social, financial, etc., and the financial aspect plays a very important role.

"The biggest financial expenses occur especially when you are required to travel abroad, for treatment that is not offered in our country. Because unfortunately there are treatments that we are not able to get here.

Thankfully, in these situations, people are wonderful and willing to help you. Personally, family, society, friends, work, colleagues and even people I have met very little in life have helped me a lot. Everyone has helped me and made me appreciate life more" - says Mrs. Dollan.

Asked how the issue of covering the cost of treatments by the state practically stands, Matilda explains that the cure therapy varies depending on the disease.

"The therapy I followed was one of the most advanced in the world, and I was lucky that only a year or two before my diagnosis, it was also introduced in Albania. The costs of the treatment were covered by the state, except when there was a shortage (this happened, including the period of chemotherapy sessions I attended from April to September 2020, due to the pandemic situation).

The help that the state offers in this case is extraordinary, since the prices of therapies for oncological diseases are unaffordable for all incomes of an individual" - she says, but she does not exclude cases where various medications are missing and she will have to they find them themselves, through acquaintances abroad or doctors.

She also explains that the economic difficulty for patients is also related to the fact that many women, due to interventions in their breasts, weakening of the immune system and general physical condition from chemotherapy and radiotherapy, are unable to work.

“Parts that experience interventions and weaning are limited to jobs that do not require physical effort, as they risk edema or need physiotherapy sessions to recover. In some cases, there may be a need for social assistance (camp) or psychological assistance," she says.

In addition to hospital treatment (chemotherapy/radiotherapy), this disease continues to be treated in the following years with drugs that can be obtained with a reimbursable prescription given by a specialist doctor, in the network of public pharmacies.

"We also mention patient expenses for special tests that are not covered by the state, such as tumor markers or genetic tests, checks such as bone scans. PET Scan, which are not accessible in the public health system.

This is a difficult path and in some cases requires increased expenses for continuous analysis/checks in private institutions, depending on the development of the disease and to gain more time.

Nutrition is another factor that plays a big role for cancer patients, adding to the cost of living," concludes Ms. Dollan.

What happens when a patient is diagnosed with a tumor?

Oncologists claim that medical care for cancer patients in Albania is constantly improving, and efforts are under the leadership of health authorities to provide more efficient and accessible treatments.

However, financial challenges and access to treatment can still be a problem for some patients, and assistance from civil society organizations and various coverage programs are important in this context.

According to the information received, when a patient in Albania is diagnosed with a tumor, there is a process that begins for their treatment and medical care. Here are some key steps that happen in this situation:

-Diagnosis: The diagnosis of tumors is important and usually begins with the consultation of a specialist doctor. Patients may be referred for various imaging tests such as X-ray, CT, MRI, or PET-CT, as well as for biopsy that will confirm the type and stage of the tumor.

-Treatment planning: After confirming the diagnosis, a medical team will design a personalized treatment plan for the patient. This plan may include surgery, radiotherapy, medical therapy, or a combination of these, and will be based on the nature and stage of the tumor.

-Treatment: After planning, the patient will start the treatment. Treatment of tumors can be done in public or private hospitals in Albania.

In most cases, treatment is available locally and can be covered through public or private health insurance, but there are cases where patients have to pay for it themselves.

- Help and support: Various civil society organizations and patient groups offer help and emotional support to patients and their families. They offer information, advice and financial help with treatment in some cases.

- Follow-up and monitoring: After treatment, patients will be monitored and have regular medical check-ups to assess the efficacy of the treatment and detect signs of tumor recurrence.

CHALLENGE

One of the main challenges that come with the high costs of treating tumors is access and direction of health care. In countries with poor health systems, patients are forced to make difficult decisions about their treatment based on their personal finances and the health coverage they have.

In the process, some patients may feel constrained by the cost of treatment, risking delay or refusal of necessary medical care.

Another important aspect is the investment in science and medical research aimed at developing more efficient and cheaper ways to treat tumors.

According to the doctors we contacted, research in the field of oncology is constantly growing, but the challenges of financing and developing innovative therapies often leave questions about access and costs. Efforts to reduce costs and ensure that cancer treatment is accessible to all are an important part of the debate in global health.

Early diagnosis

Early diagnosis is one of the most effective strategies in reducing the number of cancer deaths. Educating the population about early symptoms and coordinated screening programs and facilitated access to medical services are among the main ways to achieve early diagnosis.

According to studies that have investigated access to health care in high-risk groups in the population; The 2018 Health Vulnerability Study shows that between 75% and 95% of those who needed care/treatment, or who were advised to have further screening, were able to get it in the public sector.

Access is lower in groups with high vulnerability (poor individuals, the unemployed, the Roma community, etc.) and in some specific categories it falls even below the 50% target of the strategy set by the authorities.

As for the screening programs, mammography screening for breast cancer, Pap test and HPV test for cervical cancer and colorectal cancer screening with fecal occult blood included in the annual check examinations are being carried out in Albania. -up.

"Although prevention and early diagnosis efforts have increased in recent years in Albania, there is still much room for improvement so that they have a higher impact on reducing the number of new cases and reducing the number of deaths from cancer", says oncologist Euglent Hoxha.

A year ago, the Ministry of Health and Social Protection presented the National Cancer Control Program 2021-2031, in which it is stated that, for the first time in Albania, the financing of the HPV vaccine for the prevention of cervical cancer in women began. vaccine which starts at the age of 11.

When a drug is missing for a cancer patient, the situation becomes worrisome and can have serious consequences for the patient's health. Some of the challenges are:

-Delay in treatment: The lack of a drug often causes delays in the treatment of the patient. This can have negative consequences on the efficacy of the therapy, allowing the disease to worsen.

- The risk of deterioration of the health condition: In cases where the drug is essential for the control of the disease, the absence may worsen the patient's health condition.

-Stress and anxiety of the patient and family: Lack of a medicine often causes stress and anxiety in the patient and his family. They may feel uncontrollable and uncertain about the outcome of the treatment.

-Additional costs for the patient: In some cases, patients or their families may be forced to purchase the medication at their own expense, adding a financial burden at a difficult time.

- Attempts to find alternatives: Doctors may try to find alternative solutions or communicate with health authorities to provide the necessary medicine. This may involve using other drugs with similar effects or trying to secure supply from alternative sources.

cost

The cost of tumor treatment in Albania depends significantly on the type of tumor, its stage, and the treatment methods used. Also, it varies depending on treatment in the public or private health care sector.

-A cycle of radiotherapy can cost from 100,000 to 250,000 ALL or more, depending on the number of sessions and the type of equipment used.

- The surgical treatment of the tumor depends on the specific intervention and the location of the tumor, but the cost of a surgical operation usually starts from 150,000 ALL or more.

-Medical therapy (including anti-tumor drugs) can have different costs, but some new and advanced drugs can be very expensive, reaching thousands of lek for a single dose./ Monitor


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