This crisis has been worsened by the transition from the NHIF to the Social Health Authority (SHA), which has caused widespread disruptions in healthcare services.
Breast cancer treatment options
Women with breast cancer have reported that a life-saving
drug, which was made widely available in Kenya through an NHIF deal two years
ago, is no longer available in many treatment centres.
The drug, Herceptin, has saved lives of millions of
women around the world and works by locking onto the roots the cancer cells. It
then stops the cells from growing and kills them.
It was made widely available in Kenya in 2022 through
a deal between the National Health Insurance Fund and the manufacturer Roche,
where NHIF would cover the entire subsidised treatment cost.
But thousands of cancer patients across Kenya who need
the drug on Tuesday complained they are struggling to access it.
This crisis has been worsened by the transition from
the NHIF to the Social Health Authority (SHA), which has caused widespread
disruptions in healthcare services.
This is according to the patients lobby, the Kenyan
Network of Cancer Organizations (Kenco).
The lobby said Herceptin, which costs Sh100,000 per
dose in private facilities, is out of stock in major public hospitals,
including the Kenyatta National Hospital and the Kenyatta University Teaching
and Referral Hospital.
The Social Health Authority currently covers only
three cycles of the drug, but patients typically require 12 to 18 cycles for
effective treatment. "Without Herceptin, thousands of women battling
breast cancer are left with no hope," said Phoebe Ongadi, the Executive
Director of Kenco, speaking on behalf of multiple cancer advocacy groups.
"Many patients have been turned away from public
hospitals or forced to buy expensive medication from private pharmacies. This
is unacceptable and puts lives at risk.”
The Star has contacted the KNH for response.
Ongadi said many patients who previously relied on
NHIF for treatment are now being denied care or forced to pay out-of-pocket due
to unclear SHA coverage. "We were assured of a smooth transition, but in
reality, patients are suffering. Some are being turned away from treatment centres.”
She said another major issue is the lack of clear
information on what SHA covers. Patients and even healthcare providers remain
confused, leading to disruptions in chemotherapy, radiotherapy, dialysis, and
other treatments. "There is no transparency. People don't know what SHA
will pay for, and hospitals are refusing to treat patients without upfront
payments," said Ongadi.
Technical problems with SHA’s system have also delayed
treatment. Patients struggle with registration, logging in, and getting
pre-authorisation for treatment, further endangering their health. "Cancer
treatment is time-sensitive. Every delay increases the risk of the disease
spreading," she warned.
Kenco also noted SHA’s budget allocation for chronic
illnesses is insufficient to meet demand. This means that when a patient
exhausts their SHIF coverage, they are left without options. The lack of funds
also affects cancer screening services, limiting early detection efforts.
"Prevention is better than cure, but without funding for screening, many
cancers will go undiagnosed until it's too late," Ongadi said.
Diagnostic delays have also become a serious issue.
The PET CT scan at Kenyatta University Teaching, Referral, and Research
Hospital (KUTRRH) has long waiting periods, causing critical delays in
diagnosis and treatment. "Doctors need scan results urgently to plan
treatment, but patients are waiting too long, which reduces survival
chances," Kenco explained.
The statement was supported by health NGOs Hennet, NCD
Alliance-Kenya and Cancer Survivors Association of Kenya.
The groups are demanding immediate action from the
government and SHA. Their key demands include restoring the availability of
Herceptin and other essential cancer drugs in all public hospitals.
They also want continuous and uninterrupted access to
cancer and NCD treatment for all patients.
They called for expanding radiotherapy services by
maintaining machines, increasing capacity, and partnering with private
hospitals.
The groups asked the state to provide clear,
transparent information on SHA’s oncology and NCD coverage so patients know
what services they are entitled to, and increasing SHA’s budget for chronic
illnesses to support long-term care and cancer screening programmes.
The other demand is ensuring NHIF prepayments are
automatically transferred to SHA, so patients are not forced to pay again for
covered treatments.
"The government must act now. Every delay costs
lives," Ongadi said.
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Breast cancer treatment options