Cancer patients, survivors and caregivers have petitioned Parliament, demanding adjustment of the annual limit in the SHA cover.
They claim the medical scheme gets depleted within months.
Currently, cancer patients are covered to the tune of Sh550,000 per household per year, down from the Sh600,000 which was offered under the defunct National Hospital Insurance Fund (NHIF).
Appearing before the National Assembly’s Health Committee, Kenya Network of Cancer Organisations (Kenco) said most families are forced to shoulder heavy burdens or abandon treatment midway.
The network represents 70 civil society groups and thousands of cancer patients, including survivors and caregivers across the country. National chairperson Philip Odiyo said most of their members exhaust their benefits in less than six months.
A survey conducted by the organisation on 118 patients and caregivers says 60 per cent had exhausted their SHA cover before the end of the year.
The study also revealed that 35.8 per cent exhaust their benefits in less than three months while another 34.3 per cent within three to six months.
“These findings confirm that the current oncology cover is grossly inadequate for the financial realities of cancer treatment and that SHA has not protected households from catastrophic health expenditure,” Odiyo told MPs.
“This policy shift has left many cancer patients with no option but to pay out of pocket, seek communal contributions through harambees or abandon treatment altogether – with catastrophic health and financial consequences.”
According to Kenco’s study tabled before the committee, among those whose cover ran out, 38.5 per cent were able to pay out of pocket, 27.9 per cent could only pay partially. “A record 20.2 per cent could not pay for treatment at all and 13.5 per cent were forced to abandon treatment completely,” executive director Phoebe Ongadi said.
They are now calling on the government to raise the package to at least Sh1.2 million per year under SHA. “We urge the Ministry of Health and SHA to increase the oncology benefit to at least Sh1.2 million per individual per year,” Odiyo said.
The financial burden of treating cancer in Kenya has reached alarming levels, with Kenco estimating that families spend an average of Sh3.8 million a year to keep their loved ones alive. The patients and caregivers umbrella body says the cost of chemotherapy, radiotherapy, surgery and follow-up medication has turned cancer into a medical and financial nightmare.
It said a woman diagnosed with triple-positive breast cancer and accessing services from a public health centre ends up paying in excess of Sh3.8 million. Kenco says a standard chemotherapy session costs Sh21,000, amounting to Sh168,000 for the recommended eight sessions while blood works cost Sh4,500, totalling to Sh36,000 for the eight cycles.
Imaging and diagnostic monitoring further raise the cost, including a CT scan (Sh20,000), echocardiograms every three months (Sh3,000) and a PET scan at Sh53,400.
The patient will also undergo targeted therapy. Herceptin alone costs Sh33,800 per cycle for 18 cycles (or more for some patients) amounting to Sh608,400.
“Kadcyla, often prescribed for maintenance or resistance cases, costs Sh180,000 per cycle for 114 cycles – a staggering Sh2.52 million,” vice chairperson Prisca Githuka said.
According to Kenco’s breakdown, hormonal therapy including Zoladex (Sh19,615 every three months indefinitely) and Letrozole (Sh5,000 for a three-month dose more than 10 years), all totaling to Sh100,000 in one year alone. The patient will also undergo Radiotherapy at an average of Sh3,600 per session for the recommended 30 sessions totaling to Sh108,000.
These, added to Sh120,000 for surgery and another CT scans of the chest and pelvis costing Sh8,000 and Sh12,000 would see a patient spending Sh3.8 million in a year.
by LUKE AWICH
