Maharashtra to include 200 cancer tests in special follow-up package
Nov 13,2023
MUMBAI: Acting on strong recommendations from Tata Memorial Centre, the state has agreed to incorporate over 200 investigations, including several cutting-edge molecular, genetic, and radiological cancer tests, into its flagship health insurance programme to improve cancer care. Crucially, the Mahatma Phule Jan Arogya Yojana (MJPJAY) has introduced a specialised annual 'follow-up package' for post-cancer treatment individuals to ensure early detection of any potential recurrence.
Earlier this year, the Tata Hospital took the initiative to assemble a committee of oncologists from diverse branches to reassess the procedures and tests included in the MJPJAY scheme since these decisions were made almost a decade ago. Following this, the committee submitted a comprehensive list of 212 pre-operative and long-term follow-up tests, ranging from traditional complete blood count tests to cutting-edge ones such as liquid biopsy, to be included in the scheme. TOI has learned that the state has agreed to incorporate most, barring some advanced liquid biopsy tests costing over Rs 20,000 because of the cost factor.
Dr Pankaj Chaturvedi, deputy director of the Centre for Cancer Epidemiology at Tata Hospital, who is a part of the committee of oncologists to reassess the procedures and tests included in the Mahatma Phule Jan Arogya Yojana (MJPJAY), confirmed the state’s approval to include advanced molecular and radiological diagnostic tests which are now integral to active cancer care in leading centres. “There are newer genetic tests now that determine the course of treatment, and circulating tumour cells, which are part of liquid biopsies, enable us to predict the likelihood of recurrence. All these are tools necessary to save lives,” he said. While welcoming the follow-up assessment package, Dr Chaturvedi said the state government also sponsoring pre-operative tests can have potential game-changing impact. “The upfront costs of biopsies, heart fitness assessments, blood tests, CT scans, and MRI tests can often lead to early-stage treatment dropouts, making state sponsorship asignificant development,” he added.
Previously, the scheme primarily focused on supporting core treatments like surgery or radiotherapy, with zero to limited coverage for pre- and post-operative tests. In the state’s flagship scheme, cancer packages remain the most availed of across 35 districts. In 2022-23, of the total Rs 1,836 crore claim amount disbursed to hospitals, nearly Rs 330 crore was solely for cancer surgeries, radiotherapy, and chemotherapy. A total of 87,216 individuals received cancer treatment under the scheme, with 45,556 opting for medical oncology, 25,245 for radiotherapy, and 16,415 undergoing surgeries in 2022-23. Notably, the number of cancer beneficiaries has increased from 66,166 in 2020-21 to 80,958 in 2021-22 and further to 87,216 in 2022-23. Maharashtra registers 1.3 lakh to 1.5 lakh new cancer cases every year.
A high-ranking official from MJPJAY said the progress in cancer care over the last decade prompted updates in the scheme. “The inclusions were made after a series of meetings with the Tata doctors,” the official said, adding that it could make Maharashtra the first among big states to integrate new-age cancer tests into its offerings. Highlighting the post-treatment assessment package, the official said Rs 20,000 can be used for follow-up tests of a patient every year. The official added that a final list of tests approved from the basket of 212 recommended by Tata doctors will be out soon with the approved rates. Another official, however, confirmed the inability to include certain expensive versions of liquid biopsy, citing the high cost of such tests, which can exceed Rs 20,000. “Governments have to evaluate the cost-effectiveness of tests to ensure optimal use and least misuse,” the official said.
Source: HealthWorld