Abstract 1339P
Background
Most cancer patients in India resort to Out of pocket expenditure (OOP), leading to loss of savings. Despite Government support, the low penetration of health insurance among other factors make long term cancer treatment unsustainable. Crowdfunding in its nascent stage is emerging as an option. The funds are raised after due diligence and verification and would be transferred to the hospital on the patient’s name. Despite the quick, attractive, direct payment method many questions remain unanswered.
Methods
A thorough web search of the main crowdfunding platfoms in India operting in Cancer treatment was done. The modus operandi of operation, diseases for which funds raised, timelines, goals acheived, information regarding donors in the public domain, financial transparency and fund usage was analysed.
Results
Milaap, Impact Guru and Ketto are the common crowdfunding platforms for cancer in India. USD 35606430 (INR 271.65 crore) was raised in 2018. Indications include hematologic, pediatric malignancies and stem cell transplant. There is no eligibility criteria and age to raise funds with no payback and cap on the amount to be raised. Donors avail tax benefit under section 80G. Donors have no say in fund usage. Coverage in private and not public hospitals (where most of the poor come). Need for access to internet, social media and technology, which is difficult for the poor and illiterate. There is no data regarding left over fund after death or intended use. Use for conditions with minimal clinical benefit (multiple relapsed/ refractory patient). Confidentiality of individual is not maintained coupled with a ethical dilemma of divulging patient information at their most vulnerable time. High commissions by the fund platforms ( close to 15-25%), which is not advertised. Poor Government regulation, with no Government players and only private entities operating currently, leading to high chance of financial impropriety. Low funds have been raised for non-pediatric conditions.
Conclusions
Crowdfunding is an emerging alternative for the poor, insurance exhausted cancer patient. Transparency, higher government hospital coverage, better state regulation to avoid financial impropriety and raising funds for cancers with higher clinical benefit is suggested.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.