Introduction: With 11.7% new cases worldwide in 2020, female breast cancer is not only the first among gynaecological cancers, but also the first cancer worldwide. Beside, the disease stage during diagnosis is an important cost-predicting factor. Methods: It was a transversal descriptive study carried out in the Obstetrics and Gynaecology Unit of the Sylvanus Olympio University Hospital (SOUH) and in the International Cancer Centre of Lome (ICCL) during July and August of the year 2022. Results: Only 146 patients were enrolled in our study, with a participation rate of 30.87%. The mean age of the patients was 48.9 ± 11.7 years with extremes of 25 and 77 years. Fifty-one patients (39%) were resellers. Sixty-four patients (43.8%) attended secondary education. The median cost of breast cancer diagnosis was 182,080 FCFA with extremes ranging from 55,680 FCFA to 487,680 FCFA. The median cost of chemotherapy was 1,640,790 FCFA with extremes ranging from 199,820 FCFA to 5,208,885 FCFA. The median cost of surgical treatment of breast cancer was 230,320 FCFA with extremes ranging from 135,240 FCFA to 368,060 FCFA. The median cost of hormonal treatment was 206,200 FCFA with extremes ranging from 36,750 FCFA to 494,850 FCFA. The median cost of radiotherapy was was 1,765,000 FCFA with extremes ranging from 1,715,000 FCFA to 2,030,000 FCFA. Of the 146 patients, 46 had not undergone any other complementary tests apart from diagnostic tests. The median cost of the tests carried out as part of the pre-therapeutic assessment and follow-up was 21,500 FCFA with extremes ranging from 0 FCFA to 824,760 FCFA. The direct medical cost of breast cancer management was 119,200 FCFA with extremes ranging from 36,616 FCFA to 1,604,669 FCFA for patients with health insurance (17.1% of patients). Conclusion: The direct medical cost of breast cancer treatment is higher than the average household income in Togo. The question of what measures could be taken to increase adherence to treatment by patients living with this cancer and to reduce a large number of long-lost patients is still pending.
Cite this paper
Ketevi, A. A. , Adani-Ifè, S. , Sena, A. K. , Besssolo, L. , Bassowa, A. , Edem, L. , Diakite, A. , Andele, K. A. , Katende, B. , Rahim, A. A. , Douaguibe, B. , Ajavon, D. R. D. , Aboubakari, A. S. and Akpadza, K. (2023). Direct Medical Cost of Breast Cancer Care in Lome: Case of Sylvanus Olympio University Hospital and International Cancer Centre. Open Access Library Journal, 10, e724. doi: http://dx.doi.org/10.4236/oalib.1110724.
Delavell, B. (2016) étude du coût de la prise en charge du cancer du sein métastatique: exemple dans un centre de lutte contre le cancer durant la période 2008 à 2015. Médecine humaine et pathologie.
https://dumas.ccsd.cnrs.fr/dumas-01583378/document
Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660
Harizi, C., Bellali, H., Hchaichi, A., Hamzaoui, A. and Chahed, M.H. (2018) Estimation du coût de la prise en charge du cancer broncho-pulmonaire en Tunisie. Eastern Mediterranean Health Journal, 24, 988-993.
https://doi.org/10.26719/2018.24.10.988
Brahmi, S.A., Zahra, Z.F., Seddik, Y. and Afqir, Y. (2016) La problématique du coût des nouvelles thérapeutiques en oncologie: Qu’En-est-il du Maroc? Pan African Medical Journal, 24, Article 51. https://doi.org/10.11604/pamj.2016.24.51.9512
Mattila, P.O., Babar, Z.U.D. and Suleman, F. (2021) Assessing the Prices and Affordability of Oncology Medicines for Three Common Cancers within the Private Sector of South Africa. BMC Health Services Research, 21, Article No. 661.
https://doi.org/10.1186/s12913-021-06627-6
Organisation mondiale de la Santé, Organisation mondiale du commerce and Organisation mondiale de la propriété intellectuelle (2021) Promouvoir l’accès aux technologies médicales et l’innovation: Intersections entre la santé publique, la propriété intellectuelle et le commerce. 2e ed. Organisation mondiale de la Santé, Genève.
https://www.wto.org/french/res_f/publications_f/who-wipo-wto_2020_f.htm
Amégbor, K., Darre, T., Ayéna, K.D., Padaro, E., Tengué, K., Abalo, A., et al. (2011) Cancers in Togo from 1984 to 2008: Epidemiological and Pathological Aspects of 5251 Cases. Journal of Cancer Epidemiology, 2011, Article ID: 319872.
https://doi.org/10.1155/2011/319872
Bassowa, A., Ketevi, A., Douaguibe, B., Fiagnon, K., Sedoh, T., Ajavon, D. et al. (2018) Décès par cancer du sein au CHU Sylvanus Olympio de Lomé: Plaidoyer pour un dépistage systématique chez les patientes à risques au Togo. Journal de la Recherche Scientifique de l’Université de Lomé, 20, 271-276.
Gnassingbé, F. (2023) Message à la nation.Au Togo, le SMIG revalorisé à 52.500 FCFA à partir de ce 1er janvier 2023. Portail officiel de la république togolaise. Publié le dimanche, 01 janvier 2023 09h: 21. Consulté le 11 mars 2023 à 20h40. Disponible sur: Togo Officiel.
https://www.republiquetogolaise.com/gestion-publique/0101-7601-au-togo-le-smig-revalorise-a-52-500-fcfa-a-partir-de-ce-1er-janvier-2023
Diallo, M., Fall, D., Mballo, I., Niang, C.I. and Charfi, M.E. (2022) Coûts médicaux directs de traitement du cancer du sein à l’Institut Joliot Curie de l’Hôpital Aristide Le Dantec de Dakar, Sénégal [Direct Medical Costs of Breast Cancer Treatment at the Joliot Curie Institute of the Aristide Le Dantec Hospital in Dakar, Senegal]. The Pan African Medical Journal, 42, Article 266.
Hughes, G., Amoah, A., Ahiabor, G. and Awoah, B. (2013) Economic Cost of Breast Cancer in Ghana: The Komfo Anokye Teaching Hospital Experience. Journal of Business Research, 6, 86-104.
Sun, L., Legood, R., Dos-Santos-Silva, I., Gaiha, S.M. and Sadique, Z. (2018) Global Treatment Costs of Breast Cancer by Stage: A Systematic Review. PLOS ONE, 13, e0207993. https://doi.org/10.1371/journal.pone.0207993
O’Neill, K.M., Mandigo, M., Pyda, J., Nazaire, Y., Greenberg, S.L., Gillies, R., et al. (2015) Out-of-Pocket Expenses Incurred by Patients Obtaining Free Breast Cancer Care in Haiti: A Pilot Study. Surgery, 158, 747-755.
https://doi.org/10.1016/j.surg.2015.04.040
Xu, K., Evans, D.B., Kawabata, K., Zeramdini, R., Klavus, J. and Murray, C.J. (2003) Household Catastrophic Health Expenditure: A Multicountry Analysis. Lancet, 362, 111-117. https://doi.org/10.1016/S0140-6736(03)13861-5
