Eunkyoung Kim1, Yoon-Min Cho2, Soonman Kwon3, Kunhee Park4. 1. School of Public Health, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea; World Health Organization Collaborating Centre for Health Systems and Financing, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea. Electronic address: keklemon@gmail.com. 2. School of Public Health, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea; World Health Organization Collaborating Centre for Health Systems and Financing, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea. Electronic address: ycho0319@gmail.com. 3. School of Public Health, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea; World Health Organization Collaborating Centre for Health Systems and Financing, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea. Electronic address: kwons@snu.ac.kr. 4. Pacific Health System and Policy, Division of Pacific Technical Support, Regional Office for the Western Pacific, World Health Organization, Level 4, Provident Plaza One, Downtown Boulevard, 33 Ellery Street, Suva, Fiji. Electronic address: parkku@who.int.
Abstract
BACKGROUND: Rising demand for services of cancer patients has been recognised by the Government of Fiji as a national health priority. Increasing attention has been paid to the lack of service of radiation therapy or radiotherapy in Fiji. OBJECTIVE: This study aims to estimate and compare the costs and benefits of introducing radiation oncology services in Fiji from the societal perspective. METHODS: Time horizon for cost-benefit analysis (CBA) was 15 years from 2021 to 2035. The benefits and costs were converted to the present values of 2016. Estimates for the CBA model were taken from previous studies and expert opinions and data obtained from field visits to Fiji in January 2016. Sensitivity analyses with changing assumptions were undertaken. RESULTS: The estimated net benefit, applying the national minimum wage (NMW) to measure monetary value for life-year gained, was -31,624,421 FJD with 0.69 of benefit-cost (B/C) ratio. If gross national income (GNI) per capita was used for the value of life years, net benefit was 3,975,684 FJD (B/C ratio: 1.04). With a pessimistic scenario, establishing the center appeared to be not cost-beneficial, and the net benefit was -53,634,682 FJD (B/C ratio: 0.46); net benefit with an optimistic scenario was estimated 23,178,189 FJD (B/C ratio: 1.20). CONCLUSIONS: Based on the CBA results from using GNI per capita instead of the NMW, this project would be cost-beneficial. Introducing a radiation oncology center in Fiji would have potential impacts on financial sustainability, financial protection, and accessibility and equity of the health system.
BACKGROUND: Rising demand for services of cancerpatients has been recognised by the Government of Fiji as a national health priority. Increasing attention has been paid to the lack of service of radiation therapy or radiotherapy in Fiji. OBJECTIVE: This study aims to estimate and compare the costs and benefits of introducing radiation oncology services in Fiji from the societal perspective. METHODS: Time horizon for cost-benefit analysis (CBA) was 15 years from 2021 to 2035. The benefits and costs were converted to the present values of 2016. Estimates for the CBA model were taken from previous studies and expert opinions and data obtained from field visits to Fiji in January 2016. Sensitivity analyses with changing assumptions were undertaken. RESULTS: The estimated net benefit, applying the national minimum wage (NMW) to measure monetary value for life-year gained, was -31,624,421 FJD with 0.69 of benefit-cost (B/C) ratio. If gross national income (GNI) per capita was used for the value of life years, net benefit was 3,975,684 FJD (B/C ratio: 1.04). With a pessimistic scenario, establishing the center appeared to be not cost-beneficial, and the net benefit was -53,634,682 FJD (B/C ratio: 0.46); net benefit with an optimistic scenario was estimated 23,178,189 FJD (B/C ratio: 1.20). CONCLUSIONS: Based on the CBA results from using GNI per capita instead of the NMW, this project would be cost-beneficial. Introducing a radiation oncology center in Fiji would have potential impacts on financial sustainability, financial protection, and accessibility and equity of the health system.