Study finds enrolling in Ayushman Bharat Scheme increased access to timely start of cancer treatment

Enrolling under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) -- India's national health insurance program -- increased access to timely initiation of cancer treatment by 33 per cent, a study has found.

Researchers, including those from the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, also found that under the scheme, patients diagnosed with cancer after 2018, when the program was launched, were at a 36 per cent higher chance of timely initiation of treatment within 30 days, compared to those diagnosed between 1995 and 2017.

The findings, published in The Lancet Regional Health Southeast Asia, showed a "significant improvement in timely initiation of cancer treatment as a result of the introduction of PM-JAY".

The researchers analysed responses of almost 6,700 cancer patients, recruited between October 2020 and March 2022, from "selected seven leading cancer care hospitals" across six states, such as Tamil Nadu, Maharashtra and Delhi.

The patients were interviewed on aspects, including health care costs and quality of life, as part of the protocol 'National Cancer Database for Cost and Quality of Life', developed in 2018 and described in a study published in the British Medical Journal Open.

Overall, the typical duration before initiating cancer treatment following diagnosis was found to be 20 days.

The duration was observed to be highest among patients with head and neck cancer (29 days), followed by that observed among breast cancer patients (25 days) and lowest among patients with haematological cancers (11 days), the researchers found.

They also found an overall declining trend in delays in the time taken before starting cancer treatment over the years, and the "slope of this decreasing trend was notably higher among patients availing benefits under AB PM-JAY".

This suggested a higher chance of timely treatment initiation for cancer patients as a result of enrolment, the authors said and attributed it to the "expansion of cancer care services under national flagship insurance program".

The team also found lower chances of delays in timely treatment initiation among those having a higher income, compared to those having a lower income.

This was the "first-ever study to cover all types of cancer patients in a nationally representative sample", according to the authors.

"Our study recommends expanding AB PM-JAY cancer packages to include cost-effective treatments, increasing population coverage under screening programs and promoting e-RUPI to reduce financial constraints associated with diagnostic services to address delayed treatment initiation due to unknown cancer stages," they wrote.

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