How much does it cost to treat cancer in Malaysia? We *try* to break it down :(

Cancer uproots people’s lives, and it’s not just the patient, but those around them – signalling the start of an ugly cycle of pain – physical, mental and unfortunately financial.

Since we can’t even begin to address the first two factors, we teamed up with our friends at Prudential to at least TRY to assess the last one – the financial burden on cancer cost in Malaysia, broken down into costs per aspect of your treatments – e.g. chemo, radiotherapy, consultations, x-rays etc. But first…

How can you ease the burden of Cancer?

Insurance plans are of course a good way of doing this, but they CAN get pretty complicated and expensive. Some  plans cover a broad range of other illnesses, while others are just too expensive or too complicated. Others don’t like being told the specifics of HOW to spend their money, e.g. no alternative treatments etc. When 1 in 4 Malaysians has a chance of getting cancer by the age of 75, perhaps it’s worthwhile to get insurance specifically tailored to cancer. This is why Prudential created PRUcancer X.

PRUcancer X works by focusing solely on cancer, offering benefits that mature the minute you’re diagnosed. By narrowing the field of coverage, it also reduces the costs associated, and the amount of paperwork needed to approve claims. For as little as RM400* a month, you can qualify for minimum coverage of RM250,000, including compassionate benefit.

From that coverage, you get 10% of your coverage when you are diagnosed with early stage, less threatening forms of cancer, and 100% upon diagnosis of more serious cancers. Why make it so simple? Because half of Malaysian cancer victims are broke within a year. And as you’ll read in this article, it’s because cancer can get VERY expensive,

 

So how much does cancer cost in Malaysia?

Well, if you want the easy answer, check out this infographic from iMoney or this pinker one from learnmyprotection.com where it ranges from RM16,000 for thyroid cancer all the way to RM395,000 for higher breast cancer estimates. But we spoke to several insurance people, cancer patients and their families and medical professionals from both private and public institutions… and we can tell you… the answer isn’t really that simple.

“The cost is really variable and sometimes you need a combination of treatments – radiotherapy,  so that actually would escalate the cost quite considerably. You can pay RM50-60,000 at the bottom line, to several hundred thousand ringgit.” – Dato’ Dr. Mohamed Ibrahim Abdul Wahid, Medical Director & Oncologist of Beacon Hospital.

The costs can be attributed to a few factors – such as stage and type of cancer, age of patient, and also whether you go for public or private treatment, but the variations of treatments are infinite. In fact, none of the private institutions actually publish rates even on something as ‘simple’ as one chemo session or one x-ray. The few that we called told us to book a consultation to get the figures. The best we could do is an official Ministry of Health (MOH) guideline on the MAX price that private institutions can charge here.

Thankfully, Malaysia’s public healthcare is actually pretty darned good (Note: Non-citizens pay about 300% more. All prices listed in this article are referring to rates for Malaysian citizens) … and do have a few costs of treatments listed on the MOH and KL General hospital sites, which you can check out here. But to give you a better idea, here’s a rundown based on the types of treatments you’ll need, sorted from cheapest, to most expensive.

 

1. Room rates (RM3-RM2,888)

What a cancer patient might need: 1-7 days for surgical recovery (not counting chemo day care).

Let’s start at the most basic level. Whenever you have surgery, you’ll need anywhere up to a week to recover, depending on how invasive the surgery is. Luckily, if you’re not fussy about who you’re sharing a room with, gomen hospitals offer rates as cheap as RM3 a day (Kelas Tiga), and no, that’s not a typo. With aircon, and a private room, this can run up to RM80. But you’re probably not gonna get your favourite Astro channels yea (or even a TV)?

Now if you’re talking private, room rates are the only actual rates that most private institutions publish, ranging from a rather affordable RM95 a night, all the way to RM2,888 with attached dining and business areas (!).

Thankfully, regular rooms are fine for most cancer patients. Most cancer surgeries are fairly straightforward, at most requiring a week of monitoring. Only when severe complications arise do you need Intensive Care, Critical Care or even the High Dependency Ward, which can cost upwards of RM430 a night.

 

2. Consultation (FREE – RM235 per consultation)

(anaesthesiologists can cost up to RM605)

What a cancer patient might need: 4 – ∞ sessions

It’s a hard call for consultations. While each consultation isn’t so expensive by itself, they can add up over time. Each cancer is different, with its own set of complications. It could be as simple as 2 normal consultations, and one with an anaesthesiologist and then with the surgeon. Or you might need to add a radiologist for your PET Scan, and maybe another with a surgeon. If you have trauma, it might add on additional visitations with a physiotherapist. And if the cancer is one that takes a while to overcome, that might mean even more regular visitations.

For government hospitals, if you’re referred internally, the first consultation is FREE (Yay Malaysia!), but if referred from external private sources, then it’s RM30, with subsequent visits, it’s just RM5.  For private doctors, the MOH limits a max price of RM235 per specialist consultation, and can start as low as RM80. Anaeasthesiologists can cost more, up to RM630 per session, which is required before many surgical procedures.

 

3. Surgery (RM500-RM10,335 per procedure)

What a cancer patient might need: A simple removal of a lump to at the worst, invasive transplants

Costs for surgery aren’t published in very many places. Based on the MOH guidelines, surgeries shouldn’t exceed RM10,335 (7030 for surgeon and another 3305 for anaesthesiologist). This number repeats itself throughout the MOH document as the max price for anything from removal of a cranial supersellar tumour, to removal of a foot tumour with neurovascular reconstruction.

However, the reality of the situation is that one surgery might have multiple billable items (although MOH does have guidelines that multiple operations within the same surgical session should be between 25-50% cheaper). From a quick Google online, we’ve found that even a relatively simple mastectomy can cost anywhere from RM6,000 to RM12,000 for the same patient with different doctors! However, if you need a transplant, costs can go up substantially. This site quotes that a stem-cell transplant for lymphoma in Malaysia can go as high as RM100,000.

Thankfully, some government employee patients have told us that you can attain a guarantee letter from their departments which waive alot of these costs, but kenot find much details about what qualifies and doesn’t qualify you.

4. Radiotherapy (RM2-RM4,800)

What a cancer patient might need: 15-45 sessions

As an alternative to surgery, or if there’s a chance that some of the cancerous cells remain, doctors usually prescribe a combination of radio and chemotherapy. Radiotherapy basically uses ionizing radiation to damage the DNA of the cancer cell, and hopefully to kill it.

Government hospitals offer some pretty ridiculously good rates here, from as little as RM2-10 for a superficial X-ray therapy, all the way up to RM500 for isotope radiotherapy. For private hospitals however, information again was scarce – with only one reference to costs between RM1,400 to RM4,800. However, the MOH document says that the maximum cost for radiotherapy is RM5720, although consultations can also range between RM860-1715 (wah dem precise la MOH).

Of course, there are even more expensive treatments than that. For instance, Beacon Hospital in KL offers Cyber-knife or heat-knife treatments, that use a giant robotic arm to carefully zero in and nuke the tumour, leaving more healthy tissue behind and increasing chances of living. The cost? A reputed RM67,000 a session (in this case for brain cancer).

 

5. Diagnostics (RM10-RM17,000)

What a cancer patient might need: 1-5 days for surgery recovery

According to most doctors, this is where the big money is. To treat a cancer effectively, doctors need as much information as possible. Some could be as simple as just an X-ray (RM10-200 for government hospitals) followed up by surgery, or others could spend on CT or MRI scans (up to RM1600 for a full brain scan). It doesn’t stop there though… those with better finances can go with something extraordinary like Oncodeep (RM17k + 3k for subsequent sessions), which analyses a DNA sample of the tumour and sends a list of recommended treatments.

The thing is, people want the best chance of surviving cancer, which often results in multiple diagnostics, and frequently as well, and this is where costs start to escalate. For example, collorectal or Ovarian cancer may require a pelvic MRI, which can cost up to RM1485 per session according to MOH, and you might have to go for multiple scans, especially if the cancer has metastasized (spread to other parts of the body). Other cases are scans at regular intervals to see if the cancer is slowing down or speeding up.

Also, the accuracy of scanning can vary wildly. Government hospital machines can do between 32-64 slices (think of it like resolution of images.. the more slices, the more info… the better they can diagnose), while some private branches offer detail of up to 128 slices, resulting in a better diagnosis, but also more cost.

 

6. Chemotherapy (RM50-RM4000 per cycle)

What a cancer patient might need: 1 – ∞ cycles

And unfortunately here, it gets even more expensive. Chemotherapy comes in a variety of forms, but unfortunately, they’re all pretty expensive. Even in government hospitals, you’re looking at RM50-200 for each treatment. For private institutions, they can range from RM170 per day, all the way up to RM1030 per cycle, and that’s not including daycare rates, which range between RM30-RM100 a day.

Unfortunately, take home drugs aren’t any cheaper. While you do save on daycare, these scary pills can cost as much as RM500 a pill, sometimes even more. Imagine taking one every day for a month, and you’re getting an idea of how expensive chemotherapy can become.

An unfortunate side effect of chemo is also that the powerful chemicals can cause your veins to shrink to the point that you can’t take them via an IV. Some patients who might have complications might have to open up new avenues to inject the chemo, e.g. through your tummy (*ouch*), and these procedures might cost up to RM2830.

 

And there are loads of costs and combinations not covered here ugaiz 🙁

If you’ve made it this far, you probably know that this list isn’t anywhere near complete. A real cancer case can involve all of the above, and it might not even end there if the cancer isn’t completely cured. Also, some insurance plans don’t even cover early stages of cancer, or any alternative/experimental treatments you might be looking at. Plus…

“In Malaysia, non-medical costs are very important as well – travel to and from hospitals – people coming from outstation because most of the cancer treatments are in KL. Then they have to get someone to take care of their child, some people need to buy a wig for their hair, physio therapy, dental care, parking fees. These things really add up.” – Dr. Nirmala

While public hospitals are thankfully affordable in Malaysia, the waits for diagnosis and unavailability of treatments can sometimes reduce your chances of survival significantly.

This is why Prudential created PRUcancer X – a cancer plan that pays out regardless of the costs you incur. In an early stage, you’ll get 10% of the total payout (up to RM2 million depending on the plan), and at the unfortunate later stages, you’ll have access to the entire sum assured; and in the unfortunate event of death, an RM10,000 compassionate benefit.

Cancer is a very personal disease – when you’ve got your own life in your hands, time and money are of the essence. While time is a hard thing to buy, a bit of spare cash and the right plan can make all the difference.