Cancer treatment in Mexico and the Seguro Popular August, 2012 1 - - PowerPoint PPT Presentation

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August, 2012

Cancer treatment in Mexico and the Seguro Popular

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Contents

• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses Protection

Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

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! Welfare loss to society

• In 2008, global economic loss due to premature death and disability from cancer was $895 billion US

dollars, then equivalent to 1.5% of the world’s GDP.

• The American Cancer Society estimated that 83 million years of “healthy life” were lost to cancer.

! Epidemiological evolution

• Cancer is no longer a disease of rich countries or of rich people within societies, it is a public health

issue with vast economic implications for all national health systems.

• In 2008 cancer was the top cause of mortality, 13% of global deaths, 7.6 million. Of all deaths due to

cancer, 60% occurred in developing countries.

• For Mexico, malign tumors are the third most important cause of death with a mortality of 29.3 deaths

per 100 thousand inhabitants in 2008, behind Diabetes mellitus and ischemic heart disease.

! Increased demand for services

• In 2004 Mexico had 135 thousand discharges as a result of treatment of malign tumors, by 2010 the

total number of discharges was 178 thousand, an increase of 31.8%.

• From 2004 to 2012 the Catastrophic Expenses Protection Fund managed by the Health Ministry has

financed 92 thousand cancer cases with a cost of 703 million US dollars.

Cancer as a public health and economic priority issue

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses Protection

Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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Mexico’s Social Protection in Health System insurance mechanisms

Seguro Popular

Catastrophic Expenses Protection Fund (FPGC)

• Funds are transferred directly to the

service provider after treatment is supplied on a pay per event basis

! 284 interventions for preventive attention and general hospital procedures covering more than 1,500 diseases and 522 medicines. Universal Catalogue of Health Services (CAUSES)

• Funds are transferred to and
• perated by states’ health services

according to enrollment in Seguro Popular

! 58 interventions for high cost medical treatment and low incidence diseases that generate catastrophic expenditures.

* Includes bone marrow transplant and Non-Hodgkin lymphoma for adults over 18 years old and testicular cancer

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System of Social Protection in Health: Affiliation coverage

Since the inception of the Seguro Popular 52.7 millions of individuals have financial protection to access healthcare Millions of Mexicans enrolled in Seguro Popular

5.3 11.4 15.7 21.8 27.2 31.1 43.5 51.8 52.7 2004 2005 2006 2007 2008 2009 2010 2011 2012

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Evolution of the Catastrophic Expenses Protection Fund´s coverage

3 3 4 20 43 49 49 56 58 2004 2005 2006 2007 2008 2009 2010 2011 2012

Number of diseases included in the Catastrophic Expenses Protection Fund

Year of inclusion by type of pathology 2004

• Cervix-uterine cancer
• HIV/AIDS
• Neonatal Intensive care

2006

• Cataracts
• Congenital and acquired surgical Disorders
• Bone marrow transplant and ten types of

tumors in patients under 18 years old

2007

• Congenital cataracts
• Breast cancer

2008

• All cancer in children and teenagers under 18

years old

2011

• Bone marrow transplant in adults
• Non-Hodgkin Lymphoma
• Testicular cancer
• Cornea transplant
• Acute myocardium attack
• Lysosomal diseases
• Hemophylia

2012

• Prostate cancer
• Kidney transplant for under 18 years old

30 interventions of the Catastrophic Expenses Protection Fund´s finance treatment for diverse cancers

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2004 2007 2008 2006 2011

Evolution of cancer treatment through Seguro Popular

• Cervix-uterine cancer
• Acute lymphoblastic leukemia
• Bone marrow transplant and ten

types of tumors in patients under 18 years old

• Breast cancer
• Bone marrow transplants in adults
• Non-Hodgkin Lymphoma
• Testicular cancer
• Prostate cancer

Inclusion of different types of cancer in the Catastrophic Expenses Protection Fund

• Financing for various ailments have

been included through the Catastrophic Expenses Protection Fund

• Attention to different age groups has

expanded in treatments such as Bone Marrow Transplants, since 2011 it is covered for adults and children

• All children, all types of cancer

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses

Protection Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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2813 4155 6893 11394 15590 2474 2981 3386 3481 4768 7049 7752 2004-2005 2006 2007 2008 2009 2010 2011

Analysis of cancer treatments covered by the Catastrophic Expenses Protection Fund

During the period 2004 - 2011 the Catastrophic Expenses Protection Fund managed by the Health Ministry has financed 90 thousand cancer cases with an investment of 682 million US dollars

Cases treated per year by type of cancer Cases treated and expenses by type of cancer 2004-2012

212.24 406.56 76.35

Cancer in children Breast cancer Cervix - uterine cancer Cases Millions of US dollars Cervix-uterine cancer Cancer in children Breast Cancer

* Data updated up to June 2012.

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses

Protection Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

12 337 622 1'478 1'564 1'849 2'372 3'911 4'614 2004 2005 2006 2007 2008 2009 2010 2011

Cases of cancer in children and teenagers

From 2004 up to 2011, 16,747 cases of children with cancer have been treated investing a total amount of almost 208.4 millions of US dollars Number of cases of cancer in children and teenagers

* Data updated up to June 2012.

13 43.1% 7.9% 5.7% 5.1% 38% Acute Lymphoblastic Leukemia Acute Myeloblastic Leukemia Hodgkin’s Lymphoma Soft tissue Sarcoma Others *

Most common diagnoses registered in children and teenagers with cancer

Acute Lymphoblastic Leukemia accounts for 43.15% of all diagnoses

* Non Hodgkin Lymphoma, Osteosarcoma, Astrocytoma, Retinoblastoma, Wilms tumor, Medulloblastoma, Gonadals, Neuroblastoma, Bone marrow transplant, Histiocytosis, Diverse carcinomas, Hepatoblastoma, Ewing’s sarcoma, Extragonadals, Ependymoma, Chronic leukemias, other renal cancers, Hepatocarcinoma, Preleukemic syndromes.

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses

Protection Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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Number of cases of breast cancer and investment

• n its treatment

2'813 4'155 6'893 11'394 15'590 2007 2008 2009 2010 2011

* Data updated up to June 2012.

Number of cases of breast cancer From 2004 up to 2011, 40,845 cases of breast cancer have been treated investing a total amount of almost 396 millions

• f US dollars

16 1.80 5.20 10.30 15.00 16.90 15.40 12.20 8.40 6.00 3.90 2.50 1.90 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 75 76 to 80 81 and above Age

Percentage of breast cancer cases treated by age group

70% of breast cancer cases occur between the ages of 36 to 60 years old

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses

Protection Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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Number of cases of cervix-uterine cancer and expenses destined to treatment

269 2,205 2,981 3,386 3,481 4,768 7,049 7,752 2004 2005 2006 2007 2008 2009 2010 2011

Number of cases of cervix – uterine cancer From 2004 up to 2011, 31,891 cases of cervix-uterine cancer have been treated investing a total amount of almost 76 millions of US dollars

* Data updated up to June 2012.

19 2.0 4.5 9.2 13.1 13.8 15.1 11.9 9.6 6.8 5.8 3.4 2.9 1.0 0.8 19-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 60-65 66-70 71-75 76-80 81-85 86-96 Age

Proportion of cases of cervix-uterine cancer treated by age group

63.5% of cervix-uterine cases occur between the ages of 36 to 60 years old

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses Protection

Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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Results of cancer treatment in Seguro Popular’s affiliated population

Children with cancer

• The survival rate in children with cancer has increased, currently 7 out of 10 children

survive the illness at the 30 month follow-up benchmark.

• The treatment dropout rate has decreased from 30% to 5%

Breast cancer

• The survival rate reported in women at the 30 month follow-up benchmark is between

80 to 94%

• Adherence to treatment increased from 75% to 98%

Cervix-uterine cancer

• Early detection and treatment funded by the Catastrophic Expenses Protection Fund

has helped to diminish the mortality rate, which fell from 8.4 deaths per 100 thousand women in 2003 to 7.4 in 2008.

• As a result of Seguro Popular’s funding for breast cancer treatment it has been

possible to attend more women. Nonetheless it is necessary to strengthen detection activities at stage I in order to guarantee a higher survival rate

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• 1. Cancer as a public health and economic priority issue
• 2. Mexico’s Social Protection in Health System
• 3. Analysis of cancer treatments covered by the Catastrophic Expenses Protection

Fund

• Cancer in children and teenagers
• Breast cancer
• Cervix-uterine cancer
• 4. Results of cancer treatment in Seguro Popular’s affiliated population
• 5. Challenges for cancer treatment policy

Contents

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Challenges for cancer treatment policy

! To better attend to the issues of cancer as a chronic non-communicable disease we should pay particular attention to the following actions:

• Reduce Risk Promote healthy lifestyles and preventive measures such as

vaccination.

• Early detection Improve clinical skills and self exploration
• Treatment. Standardize and improve treatment protocols. Ensure the availability of

highly trained staff to any person in need of health services, Innovate on treatment delivery.

• Palliative measures Increase palliative services and pain relieve
• Survival Create Survivorship programs and facilities to incorporate those that survive

to the labor market.