Cancer as one of South Africa’s biggest killers, and according to Discovery Health, the second leading cause of death in the world. A recent study published in The Lancet medical journal predicted that there would be a 78% increase in cancer incidence in South Africa by 2030 and a 75% increase globally. 

In light of World Cancer Day this week, Discovery Health Medical Scheme (DHMS) released a report looking at the top cancers affecting South African men and women, the average cost per annum of cancer treatment and drugs, and where SA’s cancer stats are sitting today.

Top 3 cancers affecting women

The report, titled Discovery Oncology Claims Tracker, reveals that globally, cancer accounted for 9.6 million deaths in 2018 – meaning that every one in six deaths was cancer-related. It went further to add that cancer causes more deaths than HIV and AIDS, tuberculosis and malaria combined. 

The top three cancers with the highest incidence for women included (in this order):

1. Breast cancer 
2. Cervical and uterine cancer
3. Lung cancer 

Oncology treatment costs

Now, the huge cost of cancer treatment in South Africa has been a contentious issue for a very long time, with oncology drugs being one of the biggest cost drivers in one’s cancer journey. While we know this to be the case, we rarely get specific insight into the average costs of cancer treatment and these insights were one of the key outtakes from the Discovery report, which outlined how much they spent on cancer per annum.

“In 2018, Discovery Health Medical Scheme paid out 3.5 billion for oncology-related claims,” Dr Ryan Noach, CEO of Discovery Health, said in a statement about the report.

READ MORE: 11 Symptoms Of Breast Cancer In Women That Aren’t Lumps

“Looking back, between 2011 and 2018, the total cost paid by the scheme for oncology-related treatment has increased by a significant 135%. A combination of factors has contributed to this increase, including an increased prevalence of cancer, increased costs of cancer treatment and the introduction of new high-cost therapies.”

The report revealed that the average cost for cancer treatment per member in the first year is a whopping R173 065.

The specific costs per member for treatment in the first year for some of the most prevalent cancers are as follows: 

• Breast cancer: R207 561 
• Prostate: R123 334
• Melanoma (the most serious type of skin cancer): R118 621 
• Urinary: R155 379
• Thyroid: R94 990
• Haemotology: R264 567
• Ovarian: R236 834
• Central nervous system: R523 933

Out of all these cancers, the costliest cancers to Discovery are prostate and breast cancer. 

“Even though these cancers have a relatively low average cost, the prevalence is high and therefore they result in the largest cost to the scheme,” the report says. 

The report also identified high-cost medicines and outlined three of some of the most expensive. These included (with the amount paid per month for the drug only in 2019): 

• Brentuximab Vedotin (can be used for classic Hodgkin’s lymphoma; anaplastic large cell lymphoma): R102 543 p/month
• Pembrolizumab (can be used for metastatic non-small lung cancer; metastatic melanoma): R90 550 p/month
• Lenalidomide (can be used for multiple myeloma): R63 223 p/month 

“The amount paid for high-cost drugs for oncology has increased by 145% from 2011 to 2019 compared to an increase of 4% in the amount paid for other oncology drugs,” the report says. 

“The proportion paid for high-cost oncology drugs has increased significantly to a total of 86% of all oncology drug costs in 2019. This is a reflection of changing trends in oncology with a switch to targeted therapies or immunotherapy drugs. Oncology high-cost drugs spend makes up 42% of all high-cost drugs spend.”

Additional key findings:

• From 2011 to 2018, there was a 24% increase in new cancer diagnoses and a 58% increase in DHMS members actively receiving treatment.
• In 2018, 8 731 members (0.31% of all DHMS members) were newly diagnosed with cancer and 36 939 members (1.32% of all DHMS members) received cancer treatment through the scheme’s oncology benefit. 
• Between 2011 and 2018 there was an increase in new cancer diagnoses in adults across both genders (23%) and children (18%).
• Among members older than 65 years, cancer prevalence has increased significantly since 2011. In 2018, 8.3% of all members between the ages of 65 and 80 were treated for cancer. This age group also experienced the highest incidence in 2018. 
• Rates of new cancer diagnosis are 17% higher in men than women. 
• Women aged 36 to 55 have higher rates of new cancer diagnoses than men in that age group. 
• From age 56 on, men have a significantly higher rate of new cancer diagnoses than women.
• In 2018, the scheme paid out R3.7 million in claims for a 45-year-old member with leukaemia. 
• Cancers of the central nervous system had the highest average cost during the first 12 months after diagnosis, at around R524 000 per member.
• Due to their high prevalence, claims related to breast and prostate cancer made up the bulk of what was paid out by the scheme in 2018.