Treatment cost of colon cancer at a South African tertiary academic hospital

Abstract

BACKGROUND : South Africa has a high mortality-to- incidence ratio for colon cancer, highlighting the poor outcome relative to incidence and underscoring the urgent need for public health action. Costing studies can be leveraged to understand the treatment cost burden, providing crucial insights for resource allocation. This study aimed to estimate the treatment costs for colon cancer by stage, from the perspective of healthcare providers at a tertiary healthcare facility in South Africa. METHODS : An ingredient-based approach was used to assess the stage-specific treatment costs of colon cancer at a South African tertiary academic hospital. A two-step costing process was adopted. First, treatment components were defined based on facility guidelines and verified through expert interviews, linking these components to relevant cost items for each cancer stage. Second, a bottom-up costing method was used to estimate and aggregate per-patient costs across treatment components for each stage. All capital items were annuitised using a rate of 3% and sensitivity analyses were conducted. All costs are reported in South African Rands (ZAR) and United States Dollars (USD) as per 2024 exchange rates. RESULTS : Identified colon cancer treatment components at the tertiary hospital include staging and risk assessment investigations, clinical consultations, surgery and chemotherapy. The estimated per-patient costs for treatment were R60,156 ($3216) for stages I and II (low-risk); R75,132 ($4017) for high-risk stage II and stage III; and R171,935 ($9193) for stage IV(resectable cases). Surgery represents a major treatment cost driver. CONCLUSION : Colon cancer treatment costs are substantial and increase with advancing stage. These findings highlight the potential cost savings from promoting early colon cancer diagnosis. POLICY SUMMARY : To mitigate these rising costs and reduce the healthcare burden, policies should prioritise early detection and invest in accessible, stage-appropriate interventions that improve patient outcomes and saves cost.

HIGHLIGHTS • Colon cancer treatment costs are substantial and increase with advancing stage. • Colon cancer treatment costs are driven predominantly by surgical procedures and inpatient care. • Early diagnosis and treatment of colon cancer can lead to significant cost savings.