Discovery recently released its Healthcare Claims tracker for the period between April 2017 – March 2018.
Discovery’s Health Medical Scheme (DHMS) provides healthcare cover to over 2.7 million members which represents 31% of the total medical scheme population and 56% of the open scheme population.
The majority of members reside in metropolitan areas such as Cape Town, Durban, Johannesburg and Pretoria and 46% of the scheme’ss total members live in Gauteng, while 20% live in the Western Cape.
A large part of the report focuses specifically on Oncology claims, with Discovery paying out R3.1 billion for oncology treatment over the time period.
It noted that 34,981 members were actively claiming for oncology treatment in the past 12 months, while a total of 50,684 members were registered for the oncology benefit.
“The number of members receiving treatment for cancer has increased by 99% since 2010, while the membership of the scheme has only increased by 24%,” Discovery said.
“This indicates a combination of increasing incidence of cancer as well as anti-selection.”
Also known as ‘adverse selection’, anti-selection is the tendency of individuals who suspect or know they are more likely than average to place a claim in the future – in this case, they believe (or know) that they are at greater a risk of cancer than others.
Beyond Discovery’s data, stats from the National Cancer Registry shows that there were just under 57,000 cases of cancer reported in 2010. By 2014 this jumped to 75,000 cases – and by 2015 this had reached a reported 114,000 cases.
This is a breakdown of Discovery’s data:
Top 10 types of Cancer
According to Discovery, breast cancer is the most common cancer for the period with 11,683 member claimants.
By comparison, thyroid cancer has seen the greatest increase in claimants, of 11.5%, from the previous period. Lung cancer was the most expensive to treat over the period, with a cost of R28,269 per member per month.
However, Discovery’s data shows that there is no such thing as ‘cheap’ cancer treatment, with the lowest average cost – for prostate cancer – costing around R7,892 a month.
At the other end of the scale, Discovery outlined the top 10 highest individual member claims for cancer treatment – with one member claiming R3.3 million in their treatment of Lymphoma.
Discovery also highlighted that members of various ages can require oncology treatment, with the second-highest individual member claim (R3.1 million) coming from a 13 year old who was also treating Lymphoma.
These are the most common types of cancer affecting men and women, according to cancer association, CANSA.