A wave of price hikes by hospitals and the impact of naira scarcity are frustrating struggling families of advanced cancer patients like Regina that are already grappling with the cost of living crisis in the country.
Hospitals hit by soaring maintenance and consumables costs have begun to pass the buck, leaving patients scrambling for more money to cover the cost of treatment.
In some cases where the funds are raised in record time, cash scarcity has been a major headache for many patients since January. Card transactions through Point of Sale (PoS) machines sometimes fail them, while digital money transfers often work by chance.
Regina’s quotation for curative treatment of head and neck cancer was jerked up to almost N1.4 million from N1.1 million after the Lagos University Teaching Hospital (LUTH) Cancer Centre hiked the cost of chemotherapy, radiotherapy and other treatments by 15 percent in January.
The quotation was only valid for three days. But when her husband tried to pay, the transaction was declined and took two weeks to resolve. Over a million naira had been deducted from his her account and was neither credited to the hospital’s account nor reversed.
This delayed her treatment and had consequences. On one hand, she was writhing from the aftereffect of eight chemotherapy sessions that cost between N190,000 and N240,000 each. On the other hand, her blood level pitched into a steep drop, requiring several pints more.
The chemotherapy’s attempt to kill tumour cells was also depopulating healthy cells, draining her family’s pockets further for additional treatments.
For accompanying relatives like Regina’s husband, the brightly lit wards of the NSIA-LUTH Cancer Centre, the cool caresses of the air conditioners and the warmth of attendants are never enough to lift patients above the ordeal in accessing care or the hammering of the disease itself.
He sat at the reception with a forlorn look, his elbows resting on his thighs and hands leaning on his chin as he waited for his wife to conclude her therapy that March afternoon.
It’s a tiring race with no end in sight, he said, groaning over the weight of the cost of managing the condition of a wife that was once leading a peaceful life in England barely two years ago.
“I’m tired. I’m even thinking of trying the native method. I suffered going back and forth from banks before my wife could be treated. She was chubby when we started this journey. But now, she has shrunk, I can’t notice much improvement and we keep spending,” he said.
Double whammy
Many patients are faced with the double whammy of raising cash for what is considered one of the most expensive diseases and moving past the payment hurdle. Cancer accounts for 13 percent of deaths in Nigeria, according to the African Organisation for Research and Training in Cancer.
BusinessDay’s sources at LUTH said the cancer centre has recorded a 100 percent increase in applications for financial support to cover treatment in 2023. The centre has had to reflect on the impact of the country’s staggering economy, and the scarcity of fuel and cash, among other issues, adding as much as N500,000 to patients’ bills.
It has also had to halt the use of PoS machines for payment as cases of failed transactions spiralled. It typically required the intervention of its accounts department to resolve the payment discrepancies, which sometimes lasted months.
“We changed our prices in November but it didn’t take effect till mid-January. The cost of the drugs changes and affects how we sell. We give them at the buying price most times. It is our additional charges, which are usually in administration and consumables, where we mark profit,” a source said.
“But recently, we have had a lot of issues with banks not reflecting patients’ payments. The patients almost don’t get their money until maybe a month after and this happens a lot. We try to call the banks on our end and they often have to ask patients to go back to their banks.”
The NSIA-LUTH Cancer Centre is almost the most modern cancer specialty that is government-run in Lagos state. Its capacity to provide rare radiotherapy services has made it a national rallying point for cancer patients.
Other government-run hospitals such as the Lagos State University Teaching Hospital (LASUTH) also provide chemotherapy treatments but costs have also spiked.
Findings show that chemotherapy rates have surged by 50 percent for treatments such as breast cancer while some male cancer treatments now go for as much as N500,000 per session. At least, five of such sessions could be required.
Adding to the patients’ headaches, the hospital has introduced a N10,000 maintenance fee that is charged on each chemotherapy treatment administered.
Adetokunbo Fabamwo, chief medical director of LASUTH, said cancer care in Nigeria is still reeling from the disruption of the global drug supply chain caused by the COVID-19 pandemic.
Imported medical supplies have remained unchanged at high rates in the last three years of the pandemic, worsening cancer patients’ ordeal.
“The cost of cancer treatment has gone up due to COVID-19 and the worsening economic situation of the world generally and of Nigeria in particular. When the cash crunch started it affected the speed at which people were able to pay for services, resulting in unnecessary queues. We found that people didn’t have the cash to pay and transfers were not going as quickly as they should,” Fabamwo said.
“But the PoS machines helped. Also, there is a company that helps with fee collection. That helped too.”
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At LUTH, an e-card payment system that patients can credit and use within the hospital has helped to reduce the effect of the cash crunch, a matron told BusinessDay.
The cancer centre is also using a support programme to offset the cost for patients in dire straits. “Through our support group, we encourage people to maybe raise a quarter of their pay and by the time they are done, we cover the rest of their cost,” a source said.
Also, groups such as the Lakeshore Cancer Foundation help to cover radiotherapy costs and extend support for other forms of treatment to indigents. Project Pink Blue and Medicaid Cancer Foundation also support through advocacy and screenings.
“So far, the foundation has been able to fund six patients for radiotherapy. We have also been involved in a lot of screening drives for breast and cervical cancer both independently and in partnership with different organisations,” Tolulope Adeyoola-Oladipupo, programmes coordinator at Lakeshore Cancer Foundation, said.
