Reduce GST on drugs, make available indigenous vaccines for affordable cancer treatment in India, suggests Parl panel

New Delhi: Parliamentary panel on Tuesday suggested a reduction in Goods and Services Tax (GST) for drugs and making available indigenous vaccines for affordable treatment of Cancer patients in the country, sources said.

Officers from the Ministry of Health and Family Welfare were present before a panel chaired by Samajwadi Party Member of Parliament in Rajya Sabha, Professor Ramgopal Yadav to discuss the critical issue of affordable treatment for cancer in India.

Health secretary Rajesh Bhushan, Indian Council of Medical Research DG Dr Balram Bhargava, Director General Health Services Atul Goyal were among the officers present in the meeting today.

A detailed presentation was made before the committee by the Ministry of Health. It said that out of 22 AIIMS that were working in the country, only six had facilities for cancer treatment. It was also being understood, sources said, that at least three of facilities for cancer treatment were available only on paper. Only in 13 centrally operated medical colleges, government ran cancer treatment facility.

Sources said that a member of Parliament raised how the Chittaranjan National Medical College and Hospital in West Bengal was practically defunct. Now, despite the fact that there is an inflow of patients, it refuses to decline.

Members also raised concerns about the increased price of cancer-related drugs and medicines. Despite the fact that the government claims that under certain conditions, these drugs are available at a subsidised rate, the members communicated to the Health Ministry that the situation on grassroots was not the same as being proclaimed. There was an urgent need to reduce the GST on such drugs and medicines, as suggested by the members.

Members expressed their concern about the availability for facilities and urged to conduct a PET scan which is a crucial way to detect cancer.

The members also urged the officers present in today’s meeting to declare cancer as a Notifiable Disease at the earliest because it is turning out to be a huge concern for the common man with the increased treatment price and the stigma associated with it.

A Notifiable Disease is any disease that is required by law to be reported to government authorities. The collation of information allows the authorities to monitor the disease, and provides early warning of possible outbreaks.

Further, it was discussed that counselling for Cancer patients and their family members is the most important focus that the central government needs to look at. This has been suggested by some members in this meeting.

Members were also informed by the officials that the HPV vaccine for treatment of cancer had reached its third trial stage. However, at this point, this matter is sub-judice. All the members in unison requested the central government to encourage the development of indigenous vaccines so that the treatment can be affordable and the availability of the vaccines can be ensured.

The discussion is meeting will continue on Tuesday morning when some organisations including National Cancer Institute, All India Institute of Medical Sciences (AIIMS), Jhajjar, Haryana along with Dr Bhubaneswar Borooah Cancer Institute (BBCI), Guwahati, Assam; Chittaranjan National Cancer Institute (CNCI), Kolkata, West Bengal; and National Institute of Cancer Prevention and Research, Gautam Buddha Nagar, Uttar Pradesh will present their suggestions before the committee.

The Committee is already in receipt of research from Dr Bhubaneswar Borooah Cancer Institute (BBCI), Guwahati and as furnished by Chittaranjan National Cancer Institute (CNCI), Kolkata.

The background note on the subject also received from the Department of Health and Family Welfare and Replies to Questionnaire on the subject as furnished by TATA Memorial Hospital, Mumbai during the study tour of the Committee to Mumbai on 28t April, 2022 have been circulated to the members.

In India, too, cancer is the leading cause of death, with 7.84 lakh deaths recorded in 2018, and 13.92 lakh cases reported in 2020, according to World Health Organisation.

At the national level, an average total cancer care expenditure was around Rs 1,16,218, says an expert. In private hospitals, the total cost of cancer care was estimated to be Rs 1,41,774, whereas it was comparatively lower at Rs 72,092 in public hospitals. The state-wise pattern shows that the overall cost of cancer care in India varies from Rs 74,699 in Odisha to Rs 2,39,974 in the state of Jharkhand.

In eight states, namely, Odisha, Tamil Nadu, Andhra Pradesh, Telangana, West Bengal, Chhattisgarh, Bihar and Haryana, the overall cost of cancer treatment was under Rs 1 lakh. However, cancer patients spent from Rs 1 lakh to Rs 1.5 lakh on treatment in Punjab, Karnataka, Gujarat, Kerala, Madhya Pradesh and Maharashtra. In Jammu and Kashmir, Uttar Pradesh, Rajasthan, Assam, Himachal Pradesh and Jharkhand, cancer treatment cost over Rs 1.5 lakh.

An important aspect that needs to be highlighted is the percentage share of medical and non-medical expenditure. About 90 per cent of the total cancer care expenses relate to medical care, which include expenses on doctors’ consultancy, medicines, diagnostic tests, bed charges, and other medical services like blood transfusions and oxygen supplementation. The residual 10 per cent is on non-medical heads, which includes transportation, food, escort and transport for other family members.

The state-wise pattern suggests that in two states, namely Chhattisgarh and Bihar, non-medical expenses contributed to over 20 per cent of all cancer expenditure, whereas, in nine states–Odisha, Andhra Pradesh, Jharkhand, Kerala, Himachal Pradesh, Rajasthan, Tamil Nadu, Assam and Jammu and Kashmir, over 10 per cent of the expenses were on non-medical services.

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