Acces to radiation therapy in Lebanon: current status and challenges
Caroline Jabbour ,
Lebanon
PO-1061
Abstract
Acces to radiation therapy in Lebanon: current status and challenges
Authors: Caroline Jabbour1
1Mount Lebanon Hospital , Radiation Oncology , Beirut, Lebanon
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Purpose or Objective
More than 50% of newly diagnosed
patients will receive this type of treatment. Access to radiotherapy varies
greatly between countries and depends on their level of wealth. In Lebanon, a
middle-income country, radiotherapy is well developed. However, no published
report quantifies access to radiotherapy. The recent economic crisis is seriously
altering the quality of oncology care and risking a health crisis by
compromising access to radiotherapy. The financial obstacle is expected to be
the main barrier. The main objective of this study is to do a first assessment of access to RT in Lebanon, list the most relevant barriers and propose short term solutions.
Material and Methods
A collection of the number of patients treated
per year in the radiotherapy departments all over the country was made and related to the annual
cancer incidence since 2017 until 2021. a RTU (Radiation therapy utilisation rate ) was calculated and compared to the international average. A digital questionnaire was prepared and
completed by the different stakeholders involved, focused on the evaluation of radiation therapy access and listing the main barriers to it, as well as voting on the best short-term plan to overcome the lack in access.
Results
Access to
radiotherapy (RT) in Lebanon since 2017 has been found to be below the 50% mark
but with an improving trend until 2019, then decreasing again. The limitation
of access is mostly related to new, more expensive techniques, often not
covered by third-party payers. Barriers to access are multiple but the main
reasons are financial (80.5%) in the first place, followed by the geographical
barrier (68.3%) and the absence of national standards of good oncological
practice (65.9%). The best way to
avoid a health crisis would be to make external modulation of the price through
subsidies to fill the gaps in coverage; this would be done through the creation
of a charity dedicated to these patients (73.2%). Assistance will be selective
based on criteria directly related to access barriers, the most relevant of
which are: treatment goal (palliative/curative) (75%), tumor prognosis (47%),
multiplicity of RT treatments (37%), socioeconomic conditions and patient age.
These criteria were considered acceptable by the vast majority of participants.
Conclusion
Our study was the first research work dedicated to assess access to Radiation therapy in Lebanon. It showed a lack of access compared to the international average. We succeeded to pinpoint the main obstacles to access. Since the major barrier to optimal treatment is financial, the access will be severely threatened secondary to the recent economic crisis. Short term solutions through financial support is an urgent need to maintain sustainability and quality of care.