Oncology spending rises under Chief Minister’s Comprehensive Health Insurance Scheme

Spending on cancer care under the Tamil Nadu government’s Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) has steadily increased over the years. Health officials say the amount spent on oncological treatments — medical, surgical, and radiation — was ₹142 crore in 2023, ₹147 crore in 2024, and ₹84 crore till August this year.

Coronary angioplasty and dialysis lead the list of procedures covered by the CMCHIS. “Now, medical oncology and radiation oncology are among the top 10 packages to be covered under the CMCHIS. Utilisation is increasing,” an official said.

The CMCHIS has detailed treatment protocols for oncology. All are internationally approved protocols, a senior official said, adding, “Oncology is an evolving field, and we add treatments as required. Treatments for a significant number of patients are met by the CMCHIS.”

Empanelled hospitals

Currently, 183 hospitals are empanelled under the CMCHIS for medical oncology, 171 for surgical oncology, and 52 for radiation oncology. Palliative chemotherapy is the major outgo in medical oncology, while linear accelerator and cobalt therapy are available in radiation oncology. In 2022, the packages were updated. A few drugs for immunotherapy were also added, while chemotherapy already has wide coverage, officials said.

D. Suresh Kumar, Professor of Surgical Oncology, Tamil Nadu Government Multi Super Speciality Hospital, said, “We have packages from conventional radiation therapy to stereotactic radiation therapy. All basic drugs and a few targeted therapies are covered. When we consider oncology as a whole, at least 90%-95% of the treatments are covered under the CMCHIS. Almost all surgeries, including minimally invasive surgeries, are covered.” Giving an instance, he said a specific injection used as a targeted therapy for breast cancer is covered under the scheme. “Patients need 18 injections a year. The cost of each injection varies from ₹20,000 to ₹50,000,” he said.

Kalpana Balakrishnan, chief executive officer and medical director of Cancer Institute (WIA), said the institute is one of the CMCHIS’s top utilisers and is recognised by the State government on August 15 every year. “It is mostly utilised to cover radiation treatments, and to some extent, surgery and medical oncology. The scheme also covers paediatric Bone Marrow Transplantation (BMT) and pays about ₹9 lakh- ₹12 lakh,” she said.

The CMCHIS comes into play in paediatric oncology for BMT,  Rishab Bharadwaj, Consultant, Paediatric Haematology, Oncology, Blood and Marrow Transplantation, MGM Cancer Institute, added. “In patients with blood cancers, if the cancer relapses after chemotherapy and radiation, they will need BMT. As a policy, the State government supports the treatment through the CMCHIS. We have one or two patients every month who are covered under the scheme for BMT. About ₹10 lakh is provided in the case of fully matched donors and ₹15 lakh in the case of half-matched donors. This is very beneficial for them,” he said.

Palliative care

However, Dr. Kalpana Balakrishnan pointed out that palliative care is not covered. “Cancer is a journey from screening to palliation. Treatment-wise, when nothing more can be done for a patient, palliative care is essential,” she said.

Several private hospital doctors urged the government to revise package rates in line with the rising treatment cost and inflation.