Evidence map›Paper›PMID 39522636›Full record

ArticleJournal of cancer policy2024

The out-of-pocket cost of breast cancer care in Nigeria: A prospective analysis.

Funmilola Olanike Wuraola, Chloe Blackman, Olalekan Olasehinde, Adewale A Aderounmu, Adeoluwa Adeleye, Oluwatosin Z Omoyiola, T Peter Kingham, Ryan F Fodero, Adewale O Adisa, Juliet Lumati and 3 more

Abstract read
In one paragraph

Article in Journal of cancer policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Funmilola Olanike WuraolaDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile, Ife, Nigeria; Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria. Electronic address: wuraie@yahoo.com.
Chloe BlackmanDepartment of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Olalekan OlasehindeDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile, Ife, Nigeria; Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
Adewale A AderounmuDepartment of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
Adeoluwa AdeleyeAfrican Research Group on Oncology, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
Oluwatosin Z OmoyiolaDepartment of Morbid Anatomy, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
T Peter KinghamMemorial Sloan Kettering Cancer Center, New York, NY, United States.
Ryan F FoderoMemorial Sloan Kettering Cancer Center, New York, NY, United States.
Adewale O AdisaDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile, Ife, Nigeria; Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
Juliet LumatiDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA.
Anna DareDepartment of Surgery and Dalla Lana School of Public Health, University of Toronto, Canada.
Olusegun I AlatiseDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile, Ife, Nigeria; Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile, Ife, Nigeria.
Gregory KnappDepartment of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Expanding cancer research capacity in Nigeria with team scienceD43CA260646 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI T PETER KINGHAM · 2022 to 2026
$1.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundMost patients pay out-of-pocket for cancer care in Nigeria, which can result in a catastrophic health care expenditure (CHE). There is a paucity of economic data on the cost of care and the impact this may have on the household. This study provides a prospective analysis of direct and indirect out-of-pocket costs for breast cancer care at a single tertiary care institution in South West Nigeria.

methodsConsecutive patients undergoing curative intent treatment for a new diagnosis of breast cancer between August 2019 and September 2022 were approached for enrollment. A novel questionnaire was delivered to patients during hospital admission and again during six-month follow-up. Patients self-reported annual household income, capacity-to-pay, and all direct and indirect expenditures associated with access care. A CHE was defined using three commonly used definitions, including total healthcare expenditure that exceeds 40 % of a household's capacity-to-pay, or exceeds the proportion of annual income set at thresholds of 10 % and 25 %.

resultsData were collected from 71 eligible patients with a mean age of 49.5 years (SD 11.26). Sixty-six percent (47/71, 66.2 %) of patients had ≥ Stage III disease at presentation, and 95.8 % received systemic chemotherapy. Only 23.9 % received adjuvant radiotherapy. The mean annual capacity-to-pay for the cohort was $2866.93 (SD $2749.74). The mean cost of care was $5192.77 (SD $4567.71). Out of the 71 patients enrolled in the study, between 56 (78.9 %) and 71 (100 %) experienced a CHE, depending on the included costs (direct +/- indirect) and threshold used. Sixty-six percent of patients had no form of health insurance.

conclusionsOver 70 % of breast cancer patients at a tertiary care facility in Nigeria experience a CHE because of out-of-pocket costs associated with accessing care. POLICY SUMMARY: A more effective and accessible health insurance mechanism is required in Nigeria to protect women with breast cancer from the cost of cancer care.

Indexed as

Breast NeoplasmsHealth ExpendituresAdultAgedFemaleFinancing, PersonalHumansMiddle AgedNigeriaProspective StudiesSurveys and QuestionnairesBreast cancerCatastrophic healthcare expenditureOncologyOut-of-pocket cost

Identifiers

PMID39522636
PMCPMC12067558

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.