A recent study published in The Lancet has revealed the significant positive impact that Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) made on reducing delays in cancer treatment initiation in India.
Launched on 23rd September 2018 in Ranchi, PM-JAY is one of key initiatives of Prime Minister Narendra Modi, aimed at providing affordable healthcare to economically disadvantaged sections of society.
The study, Access to Timely Cancer Treatment Initiation in India: Extent, Determinants, and Trends conducted by a team of researchers including Pritam Halder, Jyoti Dixit, Nidhi Gupta, Nikita Mehra, Ashish Singh, Pankaj Malhotra, Anisha Mathew, Lalit Kumar, Amal Chandra Kataki, Sudeep Gupta, and Shankar Prinja, analyzed data from 6695 cancer patients seeking outpatient or day care treatment at seven leading cancer care hospitals across six Indian states. The researchers involved in this study were from institutions such as the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh, Government Medical College and Hospital in Chandigarh, Adyar Cancer Institute in Chennai, Christian Medical College in Vellore, All India Institute of Medical Sciences (AIIMS) in New Delhi, Dr. B. Borooah Cancer Institute in Guwahati and Tata Memorial Centre in Mumbai.
Conducted between October 2020 and March 2022, the study used a multistage stratified sampling approach to examine delays in cancer treatment initiation (Time to Treatment Initiation, or TTI).
With the reach of PM-JAY expanding swiftly every day, it is expected that the number of cancer detections by the beneficiaries of this scheme has increased exponentially since March 2022.
As per the latest data there are 17102 public hospitals and 13830 private hospitals across India that are empanelled under PM-JAY. In the last 30 days, almost 19 lakh patients had used the card to get treatment worth Rs 3136 thousand crore. Since its launch, the number of patients is 6.86 crore and the amount that has been incurred is staggering Rs 90204 thousand crore.
As per the study, those enrolled in the scheme experienced a 90% improvement in the timely initiation of treatment compared to a 33% improvement among patients not covered by PM-JAY.
Timely treatment initiation is defined as starting treatment within 30 days of diagnosis, and as per findings, PM-JAY beneficiaries were more likely to meet this benchmark than those without coverage under the scheme.
The study found a significant decline in treatment delays after the implementation of PM-JAY.
Patients diagnosed after the scheme was launched were 36% more likely to begin treatment within 30 days compared to those diagnosed before the scheme’s launch. This number is attributed to better healthcare infrastructure, expanded financial protection, and broader service coverage that has happened under PM-JAY.
PM-JAY also played a crucial role in removing financial barriers to cancer treatment. By 2022, the number of cancer-related procedures covered under the scheme expanded from 112 to 557, including diagnostics, chemotherapy, and radiotherapy.
Additionally, the study found that 60.2% of cancer patients reside in rural areas where access to advanced diagnostic and treatment facilities is limited. PM-JAY has helped bridge this gap by improving healthcare access for these populations, allowing them to seek timely care.
The researchers employed Cox Proportional Hazard Models to analyze trends in treatment initiation, adjusting for variables such as age, gender, education, income level, and cancer stage. The study’s large sample size of 6695 participants, including data from top cancer hospitals across different regions, ensures the findings are nationally representative.
The scheme addresses the financial burden of serious illnesses, like cancer, which not only affects the individual but also impacts the entire family, leading to further hardship.
As per the study, one of the reasons for the higher share of cancer mortality in Low and Middle-Income Countries (LMICs) like India is the late diagnosis and delays in the initiation of treatment. The delay in time to treatment initiation (TTI) can lead to further upstaging of cancer, which is associated with poorer health outcomes and increased complications. In addition to poorer health outcomes, delayed TTI results in increased healthcare expenditures for treating advanced disease and its complications.
On 29 October 2024, Prime Minister Modi announced the expansion of PM-JAY to include all senior citizens aged 70 years and above, further extending the scheme’s reach.