Costs associated with the management of Wilms Tumor at Muhimbili National Hospital and Ocean road cancer institute in Tanzania, a narrow societal perspective.

Abstract

ABSTRACT Background: Non-communicable diseases (NCDs) are a major global health concern, particularly impacting Low- and Middle-Income Countries (LMICs). Childhood cancer, notably Wilms tumour (WT), presents significant challenges in LMICs like Tanzania due to disparities in healthcare access and resources. However, in Tanzania, managing WT is hindered by a lack of understanding of its financial implications. This study aims to address this gap by analysing the costs of WT management in major specialized hospitals in Tanzania to facilitate better resource allocation and cost-effective strategies. Objective: To determine Costs associated with the management of Wilms Tumor at Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute (ORCI) in Tanzania. Methods: We utilized a cross-sectional costing study for Wilms tumor (WT) management, employing micro-costing with top-down and bottom-up approaches. A 'narrow' societal perspective approach, for the financial year 2021/22 was used to identify, quantify, and value resources used for WT Care after verification at the costing unit, with exit interviews with 52 caregivers, Data analysis was done through Excel and SPSS version 20 for both provider and patient perspective. Results. The study found that the annual unit cost for managing early WT was three times lower than that for advanced WT. The annual unit costs for the early and advanced WT were 2,901,660.25 Tsh (1,104.58 USD) and 8,744,835.85 Tsh (3,328.92 USD), respectively, from the provider perspective. The oncology costing center contributed about 60% of the annual unit cost for both early and advanced disease, for patients, the cost of managing advanced WT was almost twice that of early WT. Productivity loss and treatment costs were significantly influenced by disease status. Conclusion and Recommendations. Advanced stage Wilms tumor underscores economic burden to provider and patient, as well as sustainability issues. To prevent this, cost-effective solutions must be improved.