Cancer is difficult to talk about.
It is a disease that is both profoundly personal and overwhelmingly prevalent. Most of us have experienced, either ourselves or along with a loved one, the diagnosis and treatment protocols of cancer and are well versed in its language of stages, early detection, chemotherapy, radiation, remission, and survival rates.
For many people, the emotional and physical hardship is compounded by significant financial strain. In some countries, access to primary care, diagnostics, and support for suspected cancer can be limited, and treatment can be expensive. In countries where individuals bear high out of pocket costs for health care, they are at greater risk of mortality due to cancer.
The stakes are particularly high for Asia. A 2015 study by the ACTION Study Group found that seventy five percent of patients diagnosed with cancer in Southeast Asia face financial catastrophe or death within one year of diagnosis.
ACCESS Health International recently launched a report, Innovative funding Models for cancer treatment in Asia. A landscape study of funding trends and innovations. In the report, that was commissioned by Roche, we identify innovative cancer treatment funding models from across the region that are making care more accessible and affordable, mitigating the risk of ruinous outcomes for cancer patients in Asia.
We found that partnerships are the main driver of innovative financing for cancer treatment and care. Traditional funding for cancer, which accounted for eighty percent of the models we studied, usually occurs in siloes and is ineffective at meeting demand for cancer funding at scale.
Here, we highlight five things we learned about partnerships for cancer funding in Asia:
- Partnerships drive innovative funding more than going it alone.
Of the forty innovative funding models identified in the report, seventy percent were driven by partnerships. The necessity for partnerships stems from the complexity of funding and service gaps, which cannot be resolved by any one party working alone.
Our study categorized innovative funding models by single or multiparty led and whether they featured enhanced or new funding structures. Multiparty enhanced models were most common in our study, followed by multiparty new models. (We found twice as many multiparty new models compared to single party new models.)
- Innovative funding is closely linked to a country’s level of development of universal health coverage.
The core principle of universal health coverage is to ensure that “all people can obtain the health services they need without suffering financial hardship.” Countries with advanced levels of universal health coverage are able to offer more comprehensive funding support for cancer treatment and care.
In Singapore, coverage is offered through a public private partnership model with two components, MediShield Life and Integrated Shield Plans, whereby hospital coverage is provided by the government and additional insurance is purchased through private insurers.
Similarly, the Insurance Program for Catastrophic Diseases in China, where universal health coverage is developing, is a partnership between the government and private insurers to extend coverage for severe illnesses, including but not limited to cancer, with specific policies determined by local governments.
In both examples, the state was able to create public private partnerships that go hand in hand with development of universal health coverage.
- Financing for cancer isn’t just about funding treatment; innovative funding for screening and care goes a long way in improving outcomes.
Screening and early diagnosis programs were a recurring theme in the funding models we surveyed. In Vietnam, the HPV initiative works with multiple UN agencies to help provide widespread and affordable access to the vaccine against HPV, a virus commonly linked to cervical cancer. The vaccine is recognized as an important prevention technology but is largely unaffordable for the population. As such, international organizations have stepped in to co-finance access to the vaccine.
In Singapore, the AXA 360 Cancer Care plan is the first insurance policy in Singapore that takes a holistic approach to cancer, including support for screening, treatment at all stages of illness, and comprehensive after care services. The plan includes a concierge service that works to create a seamless patient journey.
- Everyone has a role to play.
The report sets out recommendations for how each stakeholder group—governments, private insurers and financial institutions, healthcare industries, health and cancer nonprofit organizations, and international donors—can take a leadership role in creating innovative approaches to cancer funding.
An excellent example is the Development Impact Bond for HER-2+ early stage breast cancer patients in India, led by Kois Invest, an impact investment firm, in partnership with Roche and Tata Memorial Hospital. The goal of the bond is to transform the landscape for breast cancer care in India through early screening, process improvements at partner hospitals and access to targeted therapy. The bond provides support to partner hospitals in conducting opportunistic screening to identify more patients, provides funding support for necessary bio-marker tests, enables process improvements including establishment of dedicated breast clinics and extends financial support to patients unable to pay out of pocket or through insurance for HER-2+ breast cancer treatment and care. It is estimated that hospitals funded by this bond may soon see a treatment success rate of seventy to seventy-five percent or higher for HER-2+ breast cancer patients. The bond, once structured and placed, will provide benefits to approximately 12,000-15,000 patients at nine to eleven cancer care hospitals in the country over five years.
- Private sector organizations have a crucial role to play in driving collaboration.
While private sector involvement is normally targeted at specific parts of the pathway where there is a commercial rationale to instigate partnerships, their contributions have consistently served as a catalyst for innovation more broadly, leading to improved outcomes across the board. This can be ascribed to a number of key qualities unique to private sector organizations, namely valuable experience of working in a range of international environments and strong understanding of the cancer in question.
Whether led by insurance companies, pharmaceutical companies, or financial institutions, we found an array of innovative funding models initiated and led by the private sector. From early screening programs such as the Sanofi ‘My Child Matters’ program, to ManuSilver Care in Hong Kong, the private sector has demonstrated its role in ensuring equitable access to cancer detection, treatment, and care for patients in Asia.
ACCESS Health International, through our research and advisory work, will continue to study issues around cancer funding, access, and coverage. We will continue to highlight and facilitate partnership opportunities through the Health Futures network, with the goal of better outcomes for patients in Asia.
Download the full report HERE
 The ACTION Study Group. “Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries.” BMC Medicine (2015) 13:190. DOI 10.1186/s12916-015-0433-1.