National Health Insurance Policy Brief 5 The Impact

National Health Insurance Policy Brief 5 The Impact of Cancer on a Future NHI 20 August 2009

Incidence of Cancers 2009 T Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

SAHR Cancer Deaths by Type 2001 to 2005 Day C, Gray A. Health and Related Indicators. In: Harrison S, Bhana R, Ntuli A, eds. South African Health Review 2007. Durban: Health Systems Trust; 2007. URL: http: //www. hst. org. za/uploads/files/chap 15_07. pdf Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

SAHR Cancer Deaths by Type and Province in 2005 Day C, Gray A. Health and Related Indicators. In: Harrison S, Bhana R, Ntuli A, eds. South African Health Review 2007. Durban: Health Systems Trust; 2007. URL: http: //www. hst. org. za/uploads/files/chap 15_07. pdf Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Expected Incidence and Survival Prevalence South Africa Cancers for all sites except skin shown, using data from GLOBOCAN 2002 Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Incidence and One-year Survival 1994 to 2025 Uses ASSA 2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown. Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Incidence and Three-year Survival 1994 to 2025 Uses ASSA 2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown. Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Incidence and Five-year Survival 1994 to 2025 Uses ASSA 2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown. Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Incidence 1994 to 2025 Uses ASSA 2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown. Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Impact of Cancer on National Health Insurance l GLOBOCAN 2002 incidence and survival prevalence rates by age and gender tested with local oncology group and found to be consistent with their practise experience and other literature. l Combined with ASSA 2003 population projections to 2025 to show expected increase in cancer due to growth and aging of population. l Number of people in SA diagnosed with cancer for all sites except skin is estimated to have been 53, 310 in 1994. By 2009 the annual incidence is 74, 431 (an increase of 40%) and by 2025 the incidence could be 93, 060 cases (an increase of 75% since 1994). l Note however that the GLOBOCAN 2002 rates are not separated by socio-economic class and so the effects of poverty on the site of cancer are not brought through into the estimates. This needs further research. Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

Planning a Cancer Service for a National Health System l UK National Health Service: l Primary care is seen as the focus of care. l Designated Cancer Units in many district general hospitals. Sufficient expertise and facilities to manage commoner cancers – surgically led service. l Designated Cancer Centres provide expertise in management of all cancers, including common cancers nearby and less common cancers by referral from Cancer Units. Normally serve population of more than 1, 000. Paediatric and adolescent cancer services; rare cancers; plastic and reconstructive surgery; intensive chemotherapy and bone marrow transplantation; full range of radiotherapy facilities; medical oncology; sophisticated diagnostic facilities (pathology and imaging); and special expertise in palliative care and rehabilitation.

Innovative Medicines South Africa (IMSA) is a pharmaceutical industry association promoting the value of medicine innovation in healthcare. IMSA and its member companies are working towards the development of a National Health Insurance system with universal coverage and sustainable access to innovative research-based healthcare. Contact details: Val Beaumont (Executive Director) Innovative Medicines SA (IMSA) PO Box 2008, Houghton, 2041. South Africa Tel: +2711 880 4644 Fax: +2711 880 5987 Cell: 082 828 3256 val@imsa. org. za www. imsa. org. za

Material produced for IMSA by Professor Heather Mc. Leod hmcleod@iafrica. com www. hmcleod. moonfruit. com