Policy & Public Health
Ayushman Bharat boosts cancer care access but needs higher funding, finds study
FinCan study highlights improved access under AB-PMJAY while calling for increased budget and policy reforms
India’s flagship health insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has significantly improved access to cancer care by providing financial protection and timely treatment, though a substantial gap remains between current allocation and actual requirements, according to a recent study.
The FinCan study, conducted by oncologists and health economists led by Dr Abhishek Shankar, Assistant Professor, Department of Radiation Oncology at DRBRAIRCH (Dr B R Ambedkar Institute Rotary Cancer Hospital), AIIMS Delhi, offers new insights into the programme’s strengths while identifying opportunities to enhance its impact.
The authors noted that AB-PMJAY has played a key role in improving access to oncology treatments. Government data shows that the scheme has supported over 68 lakh cancer treatments worth around Rs 13,000 crore since its launch in 2018, particularly benefiting rural and economically weaker populations. Targeted therapies have formed a significant part of this progress, marking an important step in modern cancer care.
A study published in The Lancet also found that enrolment under AB-PMJAY increased the likelihood of initiating cancer treatment within 30 days of diagnosis by nearly 90 per cent compared to pre-2018 levels.
However, the FinCan study estimates that delivering a full five-year Standard of Care for cancer—including diagnostics, surgery, targeted therapies, radiotherapy and follow-up—would require approximately Rs 33,000 crore annually. In contrast, AB-PMJAY currently allocates about Rs 7,700 crore per year for cancer treatment under its existing package structure, indicating a significant funding gap despite improvements in access.
Dr Shankar, who led the FinCan study, stated that better cancer care is not only about spending more but also about spending smarter, especially where early diagnosis and well-designed coverage can prevent both late-stage suffering and catastrophic costs. FinCan models showed that faster diagnosis and treatment initiation could save around Rs 1,500 crore annually and result in 1,560 additional survivors each year.
The study also projected that early detection through screening aligned with Organisation for Economic Co-operation and Development (OECD) benchmarks could lead to annual savings of Rs 5,000 crore and over 30,000 additional lives saved.
Policy recommendations from the study focus on restructuring AB-PMJAY to better reflect the actual cost of cancer care. One key proposal is introducing a five-year revolving ceiling of Rs 25 lakh per family, replacing the current Rs 5 lakh annual cap. This would allow patients to utilise more funds during high-cost treatment periods, particularly in the first year, while ensuring continuity of care over time.
The study also suggests a Rs 10 lakh top-up for high-stage cancers, targeting around 30–37 per cent of patients who require more expensive treatment, while allowing early-stage cases to remain manageable within the revised ceiling.
To further improve outcomes, the study recommends integrating diagnostic coverage and screening support into the scheme. Diagnostics currently account for only 3 per cent of total cancer care costs but are often not covered under AB-PMJAY, leading to delays in treatment. Integrating these services through Health and Wellness Centres under the National Health Mission or including them within AB-PMJAY packages could help reduce costs and improve survival rates.
According to Dr Shankar, policymakers have already taken steps in this direction. The Union Budget 2025–26 has allocated funds to establish 200 new day care cancer centres in district hospitals to expand access and reduce out-of-pocket expenses. Additionally, customs duties on several life-saving cancer drugs have been reduced or exempted to lower treatment costs.
Overall, while AB-PMJAY has improved access to cancer care, accelerated treatment initiation and reduced financial burden, the FinCan study highlights significant scope for improvement. Strengthening early detection, revising benefit limits and integrating diagnostics and long-term follow-up care into the scheme could further enhance its impact.
Dr Shankar further emphasised that through spending smarter, India can save more lives and reduce the economic burden of cancer on households, reinforcing AB-PMJAY’s role in advancing Universal Health Coverage.
The FinCan study, conducted by oncologists and health economists led by Dr Abhishek Shankar, Assistant Professor, Department of Radiation Oncology at DRBRAIRCH (Dr B R Ambedkar Institute Rotary Cancer Hospital), AIIMS Delhi, offers new insights into the programme’s strengths while identifying opportunities to enhance its impact.
The authors noted that AB-PMJAY has played a key role in improving access to oncology treatments. Government data shows that the scheme has supported over 68 lakh cancer treatments worth around Rs 13,000 crore since its launch in 2018, particularly benefiting rural and economically weaker populations. Targeted therapies have formed a significant part of this progress, marking an important step in modern cancer care.
A study published in The Lancet also found that enrolment under AB-PMJAY increased the likelihood of initiating cancer treatment within 30 days of diagnosis by nearly 90 per cent compared to pre-2018 levels.
However, the FinCan study estimates that delivering a full five-year Standard of Care for cancer—including diagnostics, surgery, targeted therapies, radiotherapy and follow-up—would require approximately Rs 33,000 crore annually. In contrast, AB-PMJAY currently allocates about Rs 7,700 crore per year for cancer treatment under its existing package structure, indicating a significant funding gap despite improvements in access.
Dr Shankar, who led the FinCan study, stated that better cancer care is not only about spending more but also about spending smarter, especially where early diagnosis and well-designed coverage can prevent both late-stage suffering and catastrophic costs. FinCan models showed that faster diagnosis and treatment initiation could save around Rs 1,500 crore annually and result in 1,560 additional survivors each year.
The study also projected that early detection through screening aligned with Organisation for Economic Co-operation and Development (OECD) benchmarks could lead to annual savings of Rs 5,000 crore and over 30,000 additional lives saved.
Policy recommendations from the study focus on restructuring AB-PMJAY to better reflect the actual cost of cancer care. One key proposal is introducing a five-year revolving ceiling of Rs 25 lakh per family, replacing the current Rs 5 lakh annual cap. This would allow patients to utilise more funds during high-cost treatment periods, particularly in the first year, while ensuring continuity of care over time.
The study also suggests a Rs 10 lakh top-up for high-stage cancers, targeting around 30–37 per cent of patients who require more expensive treatment, while allowing early-stage cases to remain manageable within the revised ceiling.
To further improve outcomes, the study recommends integrating diagnostic coverage and screening support into the scheme. Diagnostics currently account for only 3 per cent of total cancer care costs but are often not covered under AB-PMJAY, leading to delays in treatment. Integrating these services through Health and Wellness Centres under the National Health Mission or including them within AB-PMJAY packages could help reduce costs and improve survival rates.
According to Dr Shankar, policymakers have already taken steps in this direction. The Union Budget 2025–26 has allocated funds to establish 200 new day care cancer centres in district hospitals to expand access and reduce out-of-pocket expenses. Additionally, customs duties on several life-saving cancer drugs have been reduced or exempted to lower treatment costs.
Overall, while AB-PMJAY has improved access to cancer care, accelerated treatment initiation and reduced financial burden, the FinCan study highlights significant scope for improvement. Strengthening early detection, revising benefit limits and integrating diagnostics and long-term follow-up care into the scheme could further enhance its impact.
Dr Shankar further emphasised that through spending smarter, India can save more lives and reduce the economic burden of cancer on households, reinforcing AB-PMJAY’s role in advancing Universal Health Coverage.
AB-PMJAYAyushman BharatCancer Care India
