DUBAI // Cancer patients in Dubai no longer automatically receive free chemotherapy.
At the start of this month, the Dubai Health Authority (DHA) began charging expatriates for chemotherapy sessions that had been free to all residents.
Treatment for patients who have already begun sessions will not be disrupted and the DHA will continue to pay for their chemotherapy.
Dr Hussain Abdul Rahman, the director of medical affairs at the DHA and the medical director for Dubai Hospital, said the main reason for the decision was that chemotherapy "is just so very expensive".
Dr Abdul Rahman said the onus should be on employers to ensure workers were insured, which is obligatory when hiring foreign workers in Abu Dhabi but not in Dubai.
"The Government has been paying for the cancer treatment of everyone, Emirati and expatriate, for years. But until when?" he asked.
"The cost continues to rise because the number of patients is constantly increasing," Dr Abdul Rahman said.
He said a six-month course of chemotherapy can cost between Dh100,000 (US$27,226) and Dh200,000, depending on the type of cancer and the treatment required.
"It is a huge amount, certainly, and this means that the cost has to be shared," he said.
Emiratis will not be affected by the new rule. Their cancer-related treatment will continue to be financed by the state.
But expatriates with no insurance and no means to pay the hefty bills may be left stranded. Three quarters of Indians, other Asians and Arab expatriates in Dubai have no health insurance, a DHA survey found last year.
The emirate planned to introduce universal health coverage in January 2009, requiring every employer to pay a set fee to the Government for each employee. The scheme has yet to be introduced.
"It is logical to assume that this change in policy by the DHA is to encourage every employer to provide their patient with suitable health insurance so that all healthcare needs are met," Dr Abdul Rahman said. "Every employer has a responsibility to make sure their employee is insured, and every expat coming to this country should demand insurance from their employer."
The DHA, he said, also wanted to end expectations that treatment for other illnesses would be covered by the Government.
"Why shouldn't a heart disease patient or a diabetic patient come to us and demand that we pay for his treatment, since we pay for a cancer patient?" Dr Abdul Rahman asked. "They are all sick and they all need this treatment to survive. What's the difference?"
In Abu Dhabi emirate, Tawam Hospital in Al Ain and Sheikh Khalifa Medical City in the capital have oncology departments and provide treatment for cancer patients, which is paid for by insurers.
Employers and sponsors in the capital are legally required to provide all workers with health insurance. A work permit cannot be issued without it.
But Dubai Hospital is the only government centre that treats cancer patients in Dubai and the Northern Emirates. This means the hospital sees at least 250 cancer patients a month.
Dr Shaheena Darwish, the head of the oncology department at Dubai Hospital, said this was a far cry from the 50 or 60 patients a month treated only a few years ago.
"The numbers of cancer patients in the country have increased so much and are continuing to increase, and the incidence is so high in the UAE," Dr Darwish said.
Breast, colon and prostate cancer are the three most common types in the country. Cancer is the third-leading cause of death in the country, after heart disease and accidents.
The increase in the number of patients puts a heavy financial burden on the Government, said Dr Mohammed Abbas, the president of the oncology society at the Emirates Medical Association.
"The Government cannot keep carrying the cost of cancer treatment, especially considering that the new immunotherapy treatment, which replaces chemotherapy for some patients, can cost Dh70,000 or Dh80,000 per injection, and each session is six injections every 21 days."
Cancer patients usually have two options for chemotherapy, Dr Darwish said. Chemotherapy can either be curative, which means it will be given for between three months and a year, administered every three weeks, or it can be palliative, which means it controls the cancer but cannot cure it.
A breast cancer patient who requires curative chemotherapy, for example, would receive treatments once every three weeks for six months.
"In order to get the maximum benefit from chemotherapy it has to be given on schedule, with no delays," Dr Darwish said. "Not being able to pay for treatment for one or two weeks will harm the patient."
This is why the new DHA regulations do not apply to patients already undergoing treatment, Dr Abbas said.
"We discussed it and decided to make sure none of the patients' sessions get disrupted just because they cannot pay," he said. "This is not about not wanting to help patients. This is about creating a system that works and pushing for everyone to provide insurance to their employees."
Dr Abdul Rahman said expatriates who did not have insurance should appeal to charity or humanitarian organisations to help with treatment costs.
"The burden of cancer can be shared by all," he said.