Breast cancer is a serious health problem in Indonesia, where challenges such as late diagnosis, limited healthcare access, and restricted treatment options still exist, even though the national health insurance, BPJS Kesehatan, was introduced in 2014 to improve access to care. However, socioeconomic and infrastructure barriers continue to prevent many people from receiving timely and effective treatment.
One promising treatment for HER2-positive breast cancer is trastuzumab, a targeted therapy that has been shown to improve patient outcomes and quality of life, with fewer side effects than traditional chemotherapy. However, in Indonesia, trastuzumab is only covered by insurance for patients with advanced breast cancer that has spread to other parts of the body (metastatic breast cancer) and only for six months. This limits access to the treatment, especially for patients with early-stage breast cancer, who could also benefit.
This thesis of Sudewi Mukaromah investigates the burden of breast cancer in Indonesia, focusing on the costs and the quality of life of patients treated with trastuzumab. It shows that the (economic) burden of breast cancer is still increasing. Extending coverage for trastuzumab would be cost-effective, especially for younger patients, and could greatly improve treatment outcomes. The findings suggest that expanding coverage under the BPJS Kesehatan insurance scheme could help reduce the impact of breast cancer, particularly in rural areas where access to care is even more limited.
