Healthcare Fund (HCF) implemented a policy discontinuing its coverage of medication cost of cancer patients after they complete their off-island treatment drawing flag from policy makers.

In a letter explaining the reasons for their follow-up care policy, HCF Administrator Ulai Teltull expressed that the cost of the oral chemo medication taken after the patient has returned home is more expensive than the traditional intravenous chemotherapy.

“Due to the increasing number and costs of referral cancer cases for the past three (3) years, the committee made a decision in July to terminate one (1) month supply of cancer medical drugs previously sourced during follow-up care,” stated the letter in response to Senator Rukebai Inabo’s request for explanation.

According to information provided, in the last 3 years, cancer cases referred to National Health Insurance have increased by 200%.  In 2018, out of 38 referred cancer cases, 18 died and 15 were recurring and the total cost was $1.671 million dollars.  This year so far, the total number of cancer cases have reached 48 with 12 already deceased and 28 recurring.

Furthermore, the average cost of cancer patient on traditional chemo is $28,000, whereas patient on traditional chemo and follow up therapy can be as low as $50,000 and as high as $83,000.  To show discrepancy between cost of care and contributions to the insurance, it reported  an annual premium paid for working participant as $265 whilst non-working is $164.

The letter added, “This committee understands the hardship and strive every day to treat all referral cases with fairness and human decency but the high price of treating cancer is clear indication that cancer costs is not sustainable for both medical treatment and specialty drugs.”

“After completing the recommended rounds/cycles of the IV chemotherapy, doctors sometimes recommend taking an oral chemotherapy drug and return for follow up every 3 months. As observed, these oral chemo medications is an option to prevent cancer from spreading to other body parts but will depend on test results after a given period.Cancer patients prefer oral chemotherapy for convenience and high level of comfort compared to traditional intravenous chemotherapy.”

The letter urged national congress to look at a proposal for a Chemotherapy Unit in Palau to services to Palau’s cancer cases and address many of Palau’s patients with limited funding resources. (L.N. Reklai)