Out of pocket costs and financial hardships among breast cancer patients in Egypt: a pilot study

Mennatollah Nagy Sharkawy, Hanan S. Zaky, Mahmoud Selim and Loay Kassem

Middle East Development Journal, 2025, vol. 17, issue 1, 58-72

Abstract: Breast cancer shows high global prevalence with high mortality rates and hence high financial burden specifically in low and middle-income countries (LMICs). This pilot study took place in Egypt to quantify the out-of-pocket expenses and analyze the financial burden faced by breast cancer patients under the governmental reimbursement system. The study took place at the Center of Clinical Oncology and Nuclear Medicine, Cairo University. We collected data on out-of-pocket costs, subjective financial burden and disease coping strategies through an interviewer-administered questionnaire. Then, we used descriptive statistics and Pearson correlations for analysis and the results were presented in Egyptian pound (EGP) and dollars (USD). The study included 60 breast cancer patients from Cairo University's oncology center, aged 27–75 years. The average direct medical costs, including medications, diagnostics, and medical care outside the center was 1096 EGP (35.47 USD) per month. Non-medical costs, such as food and travel, cost an average of 381 EGP (12.33 USD) per month and indirect costs of 1160 EGP (37.47 USD) per month. The total out of pocket costs of breast cancer showed an average of 2637 EGP (85.34 USD) per month. Around 32% of patients experienced catastrophic financial burden. Coping strategies included medication adjustments and lifestyle changes due to financial constraints. There was moderate positive correlation (r = 0.7) between the perceived financial burden and the number of adopted strategies. Breast cancer patients face financial challenges that may lead to impoverishment due to the excessive direct and indirect expenses associated with treating the disease. Therefore, we recommend disease screening, early detection, and facilitated access to subsidized healthcare.

Date: 2025
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DOI: 10.1080/17938120.2025.2453410

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