cancers in indonesia, 2012 - world cancer congress€¦ · siklofosfamid . sisplatin . sitarabin ....

Cancers in Indonesia, 2012 Male Female Total

Number of population 2012 (000) 122.,012 122,756 244,769

Cancer incidence (000) 138.8 160.8 299.7 Morbidity risks of cancer before age 75 years [%] 14.4 13.8 14.0

Mortality caused by cancers (000) 102.7 91.8 194.5

Mortality risk from cancer before 75 years of age [%] 11.0 8.6 9.7

Cancer prevalence on adult (000) 234.9 409.7 644.6

Total cancer prevalence [per 100.000 population] 263.6 449.8 357.7

: Ferlay, et al. (2013) dan Bray, et al. (2013)

28/11/2016 authors' perspectives 2

+ 3,200 miles

Indonesia – Pop 257 million GDP/Capita 2015, US$ + 3.400


How to reach cancer patients across country?

5,000 KM

Outline

1. ACTION Study: Household Burden of cancer patients

2. The Universal Health Coverage 3. Current Prospects and Achievements on

Cancer Treatments 4. The Prospects and Challenges


The ACTION • It stands for the ASEAN CosT In ONcology, a study

by the George Institute, Sydney. Funded by Roche Asia Pacific 10.000 new cases in 8 Countries

• Data collected in 2012-2014. Each new case was observed for 12 months after diagnosis

• In Indonesia, ACTION involved 2.335 cases from 12 centers (hospital)

• Participation was voluntary, difficult and took time


Flow of Data Collection, 2012-2014


Very difficult to follow cancer patients for 12 months without insurance coverage

Distribution of Cancer Stages at the Diagnosis ACTION Indonesia

I 7%

II 27%

III 36%

IV 30%


Catastrophic Expenditures by Type of Hospitals, % Patients. ACTION Indonesia

0

20

40

60

80

100

120

Private Public

% patients


Percent Family Complaining Financial Hardship, ACTION Indonesia

50

52

54

56

58

60

62

64

66

at Diagnosis 12 Mo later

%


Health Care Refrom was Started 2014


The Following Drugs are Covered under the Ina-Medicare

Asparaginase Bevasizumab Bleomisin busulfan Dakarbazin Daktinomisin Daunorubisin Doksorubisin Dosetaksel Epirubisin Erlotinib Etoposid Fludarabin Flourourasil Gefitinib

Gemsitabin hidroksi urea Idarubisin Ifosfamid imatinib mesilat Irinotekan Kapesitabin Karboplatin Klorambusil Lapatinib Melfalan Merkaptopurin Metotreksat Mitomisin Nilotimid

oktreotid LAR Oksaliplatin Paklitaksel Rituksimab Setuksimab Siklofosfamid Sisplatin Sitarabin Temozolamid trastuzumab Vinblastin Vinkristin Vinorelbin


Four Highest Claim Costs of the JKN, the Indonesian UHC


The Prospects and Challenges -1

• Cancer patients will continue to have better access and less household burdens in receiving cancer treatments

• Health care providers and oncologists have better chances to enhance treatments and control of cancer patients

• Pharmaceutical and medical technology companies have a better position than before in supplying cancer control and treatments


• Cancer patients in distant to limited number of cancer centers/hospitals have less access due to transportation and other non-medical costs

• Increasing cases covered by the JKN invites concerns on claim costs of the very limited resources of the first implementation of JKN

• Shortage of oncologists are not being met in a short period • Many other challenges are faced by the Indonesian UHC. • Studies and research on how to ensure adequacy and equity

of cancer control, including screening/ early diagnosis, are among the top priority for the coming years


The Prospects and Challenges -2

The Borobudur temple, built in the 9th century, was constructed for long time; it last long!!! So we expect the INA-Medicare will do


The Indonesian UHC have started and have benefitted cancer patients. However, huge challenges ahead in the wide and scattered population in

more than 5,000 inhabited islands

Disclaimer • The ASEAN Study (ACTION) was funded by

Roche Asia Pacific through the George Institute, Sydney

• The data collection in Indonesia was funded by non-product related grant by Roche Indonesia

• The claim data were provided by the BPJS Kesehatan, the National Health Insurance Corporation


cancers in indonesia, 2012 - world cancer congress€¦ · siklofosfamid . sisplatin . sitarabin ....

Documents