Prevention

Are screening subsidies enough?

The answer is ‘no.’ For instance, consider the case where breast cancer screening is subsidized, but you are uninsured an breast cancer treatment is unaffordable.  What is the value of breast cancer screening?  It is probably pretty low since if you find out you have breast cancer, there is not much you can do about it. Some individuals who value knowing whether they have breast cancer or not would still be willing to pay for screening; other individuals would not since knowing that you have cancer but no access to treatment may add stress.

This is the exact result that  Okeke, Adepiti and Ajenifuja find in their 2013 JHE article.

In this experiment we offered subsidized cervical cancer screening to women in Nigeria at randomly chosen prices. After prices were assigned, a randomly chosen subset of women were offered a lottery in which the payoff was a subsidy towards the cost of cervical cancer treatment (conditional upon a diagnosis of cervical cancer). We find support for our hypothesis: women randomly selected to receive the conditional cancer treatment subsidy were about 4 percentage points more likely to take up screening than those in the control group (an approximately 30% increase). We also show that the price of screening has a significant effect on the demand for screening: reducing the price of screening by 10 cents increased take-up of screening by about 1 percentage point (an approximately 7% increase).

The authors conclude that subsidies for medical screening may not be enough. If subsidies are warranted, they should pay not only for screening, but also subsidize treatment to further encourage screening.

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4 Comments

  1. “What is the value of breast cancer screening? It is probably pretty low..”

    While it may be true that screening can be made more attractive (and indeed more purposeful) if treatment was subsidized, treatment is not the only way a patient can (or should) react to a cancer diagnosis. It follows a revaluation of their priorities in life, widespread lifestyle changes and other measures which all ultimately make death much more bearable for them and their family. While I agree with you from a medical stand-point, I think the view you take of the purpose of screening is a bit too narrow, and while many patients may be disinterested in screenings, an increasing number now want their diagnoses revealed to them.

  2. When exposed to HPV, a woman’s immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells. -;…

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