Costs incurred by patients with oral potentially malignant disorders: is there a public health need for financial protection in India?

Objectives: Financial protection mechanisms are in place to overcome the costs of a few diseases in India. Our objective was to estimate the costs incurred due to Oral Potentially Malignant Disorders (OPMD) and to determine predictors of such costs.

Results: We found that the median (Interquartile range IQR) total costs of OPMD was Indian Rupees (INR) 500 (350-750), direct medical costs was INR 0 (0-50), direct non-medical costs was INR 150 (40-200) and indirect costs was INR 350 (250-500). The travel cost to attend the health facilities [INR 100 (40-150)] and the patient's loss of wages [INR 200 (150-400)] mainly accounted for the direct non-medical and indirect costs respectively. The median expenditure on smokeless and smoking forms of tobacco was INR 6000 (5400-7200) and INR 2400 (1800-3600) respectively. On multiple linear regression analysis, rural residence, belonging to below poverty line family, being a sole earner in the family, number of months since diagnosis and first visit at a private provider were found to be the significant predictors of total costs of OPMD. Financial protection mechanisms are needed for covering the direct non-medical and indirect costs. Early management of OPMD might mitigate the costs of OPMD.