Peka B40 Cancer Incentive Uptake Low, Fell Further To 5% In 2020

Lack of patient awareness and the burden on hospitals to assist with applications have been cited as reasons for the low uptake of the Peka B40 completing cancer treatment incentive (CCTI).

PETALING JAYA, April 18 – The Peka B40 scheme, which provides financial incentives to low-income cancer patients to complete their treatment through the completing cancer treatment incentive (CCTI) programme, has had a low uptake over the past five years, with only five to 15 per cent of eligible patients taking part.

From 2019 to February 2023, ProtectHealth Corporation Sdn Bhd, which is fully owned by the Ministry of Health (MOH), approved a total of 8,320 CCTI applications.

Izzanie Mohamed Razif, the head of medical analytics at ProtectHealth, said these approved applications resulted in a payout of RM3.82 million to over 6,000 beneficiaries. The actual number of beneficiaries is lower due to some patients having multiple cancer diagnoses.

“What I want to highlight today is that although this programme has been running for four years now, its uptake has been very low. Our colleague from the Institute for Health System Research (IHSR) conducted an evaluation of this programme (CCTI) and found that the uptake was just 5 per cent in 2020. In the previous year, it was around 15 per cent in 2019. 

“This drop in 2020 may be due to the pandemic, and we are not sure if patients delayed their treatment due to the movement control order or other issues related to the pandemic,” said Izzanie at the Oncology Summit 2023, organised by the Galen Centre for Health and Social Policy and supported by Takeda Malaysia, on March 10.

The CCTI programme offers financial incentives to motivate low-income cancer patients to complete their cancer treatment. The incentives are disbursed in two separate payments, with a maximum of RM1,000 per cancer diagnosis. If a patient is diagnosed with two unrelated types of cancer, they are eligible to make two claims. 

The initial payment of RM300 is given at the outset of treatment, while the remaining RM700 is disbursed after the patient has attended at least two medical appointments within a nine-month period.

Breast cancer is the most common cancer type among CCTI recipients, accounting for 27 per cent of all beneficiaries. Colorectal cancer and cervix uteri cancer are the second and third most prevalent types, making up 15 per cent and 8 per cent of recipients, respectively. 

Other cancer groups represented include nasopharynx (7 per cent), corpus uteri (5 per cent), ovary (5 per cent), as well as trachea, bronchus, or lung (5 per cent).

In terms of treatment, the majority of CCTI recipients (34.5 per cent) receive chemotherapy, followed by surgery (27 per cent) and radiotherapy (15.3 per cent). Other treatments covered by the programme include hormonal drug therapy (7.2 per cent), follow-up care (6.1 per cent), targeted therapy (1.3 per cent), palliative care (0.6 per cent), and radioiodine therapy (0.5 per cent).

In addition to CCTI, the Peka B40 programme run by ProtectHealth also offers a transport incentive for eligible beneficiaries, including CCTI recipients. The amount of the transport incentive depends on the distance between the beneficiary’s home and an MOH hospital.

For eligible patients in Peninsular Malaysia, the maximum amount of transport incentive per disease is RM500, while in Sabah, Sarawak, and Labuan, the maximum amount is RM1,000 per disease.

According to data from the same period between 2019 and the end of February 2023, a total of 26,660 applications for the transport incentive were approved, resulting in a payout of RM2.77 million. Of these applications, 74 per cent were submitted by CCTI recipients.

Izzanie attributed the low uptake of the Peka B40 scheme to patients’ unfamiliarity with the programme and the burden placed on hospitals to assist patients in applying for it.

“Part of the reason [for the low uptake] is that patients are not aware of the programme. Although we have advertisements on TV, cancer patients and their caregivers are [often] busy managing [their condition to notice]. While we inform hospital providers, the information may not trickle down to lower-level staff. The only person who knows is just the HOD (head of department),” Izzanie said, attributing the findings to the study by IHSR.

ProtectHealth is planning to engage with hospitals this year and find ways to simplify the application process for cancer patients, thereby reducing the burden on the hospitals.

“Most of the applications really come from the [health care] providers themselves. So whenever patients come to the hospital, the providers will check their eligibility and if they are eligible, they will enrol the patient in the scheme.

“Only a very small percentage comes from patients themselves. So from there, we know that we are not reaching out to the patients enough,” Izzanie said. 

ProtectHealth is planning to connect with the specific community by partnering with stakeholders who assist underprivileged individuals, such as eKasih, and organising in-person interactions with low-income cancer patients. 

Izzanie added that IHSR is now in the second phase of their analysis, focusing on the direct and indirect effects of the CCTI and how this incentive can assist low-income cancer patients in reducing the financial burden of their treatment.

When inquired about the success rate of applicants, Izzanie said it is approximately 100 per cent. She said any delays with applications are typically related to documentation issues.

“When the documentation is incomplete, we will follow up with the hospital to provide all the information. This scheme is applied by the treating doctor, so they would already know the criteria and they apply. I would say it’s almost 100 per cent.

“Sometimes, the pending payment is due to incorrect bank account numbers or illegitimate contact numbers. Whenever we fail to make payment due to the wrong account number, we will contact the patient. However, most of the time, the data in our system is not clean, so we cannot contact the patients directly. 

“We would have to go back to the hospital and ask the patient for the correct information because it’s related to their personal information,” Izzanie said.

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