Direct cost of treating childhood cancer in Lagos, Nigeria: A tale of financial inaccessibility to care

Background: Unaffordable health-care costs are a critical factor in poor cancer care in low and middle-income countries. Net costs of treating childhood cancer in Nigeria are largely undocumented. This study sought to define the direct cost of pediatric cancer treatment in Lagos, Nigeria, to address this knowledge gap. Methods: This was a longitudinal study design targeting determination of cost of cancer-related care delivered to newly diagnosed childhood cancer patients at the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, from January 2017 to January 2020. Study participants included children with histologically confirmed diagnoses. All direct costs associated with care from the time of diagnosis until either remission or death were documented based on a parental survey at each patient encounter. Results: Among 46 enrolled participants (median age of 6 years), leukemia was the most common diagnosis. The median duration from diagnosis to last assessment was 11 months, and the average cost directly related from diagnosis to remission or death was NGN 5,064,700 (USD 13,876). The highest cost of care was associated with rhabdomyosarcoma, with an average cost of ₦6,798,635 ($18,678). These costs were juxtaposed to the average monthly family earning of NGN 115,228 (USD 316). Conclusion: This study revealed the direct cost of managing childhood cancer in Lagos, Nigeria, which proved unaffordable for most caregivers. Policies are needed to improve the affordability of health-care delivery for childhood cancer, including a focus on the adequacy of health insurance coverage and public health-related policies governing financial support targeting health-care delivery in the context of childhood cancer to improve outcomes.