Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths in 2018. Cancer also kills more people worldwide than HIV and AIDS, tuberculosis and malaria combined.<\/p>\n
And in South Africa, the country’s largest medical aid provider, Discovery, said that in 2018, its Discovery Health Medical Scheme (DHMS) paid out R3.5 billion for oncology-related claims.<\/p>\n
\u201cLooking back, between 2011 and 2018, the total cost paid by the Scheme for oncology-related treatment has increased by a significant 135%,” said Dr Ryan Noach, chief executive of Discovery Health.<\/p>\n
“A combination of factors have contributed to this increase, including an increased prevalence of cancer, increased costs of cancer treatment and the introduction of new high-cost therapies. It\u2019s therefore no surprise that the average cost per member in their first year of treatment is R173,065.\u201d<\/p>\n
DHMS is South Africa\u2019s largest open medical scheme with 2.8 million members. The 2020 DHMS Oncology Claims Tracker investigated the incidence (new cancer diagnoses) and prevalence (members actively claiming for treatment) of the top 10 cancers affecting members from 2011 to 2018.<\/p>\n
Key findings from the report:<\/p>\n
\u201cThe data reinforces the need for greater awareness efforts around cancer and life-saving, preventative screening tests,\u201d said Dr Noach. \u201cThe fact that more members are being diagnosed with cancers that have spread to distant parts of the body, indicates that many people are still not undertaking regular screening tests for common cancers \u2013 such as breast cancer \u2013 and these are tests to which they have access through their Scheme benefits.\u201d<\/p>\n
Cancers in men, women and children<\/strong><\/p>\n Male cancers<\/strong><\/p>\n In 2018, prostate cancer had the highest incidence for male Scheme members, followed by colorectal and lung cancer. The majority of men receiving active treatment for cancer have prostate cancer, which costs an average of R123,334 during the first 12 months after diagnosis, Discovery said.<\/p>\n Since 2011 there has been a 30% increase in the number of male members newly diagnosed with prostate cancer each year and a 71% increase in members on active treatment for this cancer.<\/p>\n Female cancers<\/strong><\/p>\n The top two cancers by incidence for female members are consistent with global trends – with breast cancer being highest, followed by colorectal cancer.<\/p>\n \u201cThe number of DHMS members diagnosed with breast cancer each year has increased by 20% since 2011, with incidence increasingly significantly from age 40,\u201d saidDr Noach. The total cost paid by the Scheme for breast cancer-related treatment has also increased, but by a far larger margin – 107% – from 2011 to 2018.<\/p>\n A total of R738 million was paid towards treatment of breast cancer in 2018 alone. Breast cancer costs R207,561, on average, to treat during the first 12 months after diagnosis.<\/p>\n \u201cThe number of DHMS members receiving active treatment for breast cancer has increased significantly as a result of earlier diagnosis (linked to screening), improving survival rates and members remaining on treatment for a longer period of time,\u201d said Dr Noach.<\/p>\n Colorectal cancer<\/strong><\/p>\n The second-most prevalent cancer across adult men and women is colorectal cancer which costs an average of R313,739 to treat during the first 12 months after diagnosis. The top three biological drugs used to treat colorectal cancer have costs exceeding R100,000 per patient in 2018 and are often used in conjunction with other treatments.<\/p>\n Since 2011 there\u2019s been a 31% increase in the number of members newly diagnosed with this form of cancer, and a 58% increase in members on active cancer treatment.<\/p>\n Malignant melanoma<\/strong><\/p>\n In 2018, the Scheme paid out R114 million towards melanoma-related treatments. \u201cThere\u2019s been almost a doubling in members treated for malignant melanoma since 2011,\u201d said Dr Noach. \u201cThis is a significantly higher increase than we have seen for breast, prostate and colon cancers.\u201d<\/p>\n Cancers in children<\/strong><\/p>\n The leading tumours affecting child DHMS members are leukaemia and brain tumours.<\/p>\n How does DHMS cancer data compare to South Africa and the world?<\/p>\n The age-standardised cancer incidence rate for DHMS is higher (239 per 100 000 lives) than among South Africans (202 cases per 100 000 lives) and globally (198 cases per 100 000 lives).<\/p>\n \u201cThis is due to adverse selection in the open medical scheme environment. However the trend is likely also a reflection of the higher rates of cancer screening and diagnosis in the private healthcare sector compared to the South African and global public health sectors,\u201d said Dr Noach.<\/p>\n
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