China's Cancer Treatment Costs in Global Ranking: Is the Value for Money Truly Higher?

Within the global landscape of healthcare expenditures, China is often labeled as offering “high value for money.” But when focusing on cancer—a major public health challenge—does this conclusion still hold? As an international observer with a long-term focus on China's healthcare system, the author attempts to analyze the true competitiveness of China's cancer treatment costs through data comparisons, policy analysis, and patient case studies.

I、Global Healthcare Expenditure Comparison: China in the “Frugal” Tier

According to World Health Organization data, the United States is expected to have the highest healthcare expenditure as a percentage of GDP globally in 2025 (16.2%). China, at 4.6%, ranks 145th—equivalent to only one-third of the U.S. rate and one-quarter of Germany's. This “frugal” spending pattern is particularly pronounced in cancer care: China's annual total cancer treatment costs amount to approximately 220 billion yuan, representing 0.2% of GDP. In contrast, the United States spends a staggering $60 billion annually on lung cancer treatment alone, accounting for 0.3% of its GDP.

Looking at individual diseases, the average annual treatment cost for lung cancer in China is about 60,000 yuan, while the cost for the same disease in the United States exceeds 100,000 USD. This gap stems partly from differences in labor costs, but more critically from choices in treatment pathways: Chinese doctors see over ten times as many patients per day as their American counterparts, compressing each consultation to just 3-5 minutes. Service intensity is inversely proportional to cost.

II、Cost Structure Breakdown: Coexisting Technological Advancements and Payment Bottlenecks

China's cancer treatment costs exhibit a “dumbbell-shaped” distribution: early-stage patients incur average annual expenditures of RMB 50,000–150,000, while advanced-stage patients may incur expenditures exceeding RMB 500,000. Specific components are as follows:

1. Basic Treatment:

Surgical Fees: Traditional open gastric cancer surgery costs around ¥30,000, while laparoscopic minimally invasive surgery ranges from ¥50,000 to ¥70,000—significantly lower than the average cost of similar procedures in the U.S. (US$80,000–120,000).

Chemotherapy Fees: A single standard chemotherapy session costs approximately ¥2,000–8,000. The total cost for 6–8 cycles per year is about ¥36,000, which is only one-third of the out-of-pocket expense after insurance reimbursement in the U.S.

Radiation Therapy Costs: Conventional radiotherapy ranges from ¥30,000 to ¥50,000 for a full course. Precision techniques like proton therapy cost ¥80,000 to ¥200,000, comparable to prices in Japan and South Korea.

2. Innovative Therapies:

Targeted Drugs: EGFR inhibitors average ¥10,000 to ¥30,000 monthly. After insurance reimbursement, out-of-pocket costs range from ¥3,000 to ¥8,000—30% higher than Indian generics but with stricter quality control.

Immunotherapy: PD-1 inhibitors cost approximately ¥100,000–300,000 annually, reduced to ¥50,000–150,000 after insurance coverage, approaching levels in emerging markets like Turkey.

Cell Therapy: CAR-T therapy exceeds ¥1,000,000 per session, comparable to the U.S., but accessible to only 0.01% of Chinese patients, with adoption rates far below those of developed nations.

3. Hidden Costs:

Out-of-area medical care: Transportation and accommodation account for 20-40% of total expenses, with cross-province patients incurring approximately ¥20,000 in additional annual costs.

Nutritional support: Monthly costs range from ¥1,000 to ¥3,000. While covered by insurance in most countries, this expense is out-of-pocket in China.

Cost of misdiagnosis: Inadequate early screening rates result in 30% of patients being diagnosed at an advanced stage, causing treatment costs to surge by 3-5 times.

III、Cost-Effectiveness Debate: The Trade-off Between Efficiency and Equity

The core controversy surrounding the cost-effectiveness of cancer treatment in China lies in the tension between “technological accessibility” and “payment accessibility”:

1. Technological Level:

China has achieved internationally advanced standards in fields such as robotic surgery and AI-assisted diagnosis. For instance, a top-tier hospital in Shanghai ranks among the world's leaders in robotic lung cancer surgeries, with per-procedure costs 40% lower than in the United States.

However, significant gaps exist in primary healthcare equipment: 50% of county-level hospitals nationwide lack PET-CT scanners, and western regions have only one proton therapy center. This forces patients to concentrate in Beijing, Shanghai, and Guangzhou, driving up indirect costs.

2. Payment Dimension:

Medical insurance coverage continues to expand: reimbursement rates for urban and rural residents' insurance reach 40-60%, while employee insurance covers 70-90%. Critical illness insurance provides secondary reimbursement with a cap of 300,000 yuan.

Yet access to innovative drugs remains limited: By 2025, only 35% of globally available anticancer drugs will be included in the medical insurance catalog, with patients bearing an average out-of-pocket cost of 40%—higher than Japan (25%) and Germany (30%).

3. Patient Experience:

An international survey indicates that 82% of Chinese cancer patients are satisfied with the efficiency of diagnosis and treatment (compared to 75% in the US). However, satisfaction with cost transparency stands at only 65%, with primary concerns centered on “redundant diagnostic tests” and “drug kickbacks.”

Comparison with India: Although generic drugs in India are 60% cheaper, Chinese patients prefer originator drugs because the adverse reaction rate for Indian drugs is 2.3 times higher than that of comparable Chinese products.

IV、Future Trends: Dual-Engine Growth from Technological Accessibility and Payment Reform

China is enhancing cancer treatment cost-effectiveness through three pathways:

1. Early Screening Expansion:

Colorectal cancer screening penetration will rise from 16.4% in 2025 to 39.8% by 2030. Early-stage patients achieve 90% five-year survival rates with 70% lower treatment costs.

Low-dose CT screening for lung cancer is now included in free programs for high-risk individuals aged 40+, projected to reduce advanced-stage cases by 150,000 annually.

2. Innovative Drug Price Reduction:

Biosimilar drug procurement has lowered bevacizumab prices from ¥5,000 to ¥1,500 per vial, reducing annual patient costs by ¥80,000.

Domestic mRNA cancer vaccines have entered Phase III clinical trials, with projected treatment costs below ¥100,000—just one-tenth of imported products.

3. Payment Model Innovation:

The Huimin Bao insurance program covers over 120 million people with an annual reimbursement cap of ¥3 million, increasing coverage for innovative drugs to 70%.

Integration of commercial health insurance with basic medical insurance has reduced the actual out-of-pocket ratio for advanced cancer patients from 45% to 28%.

Conclusion: The Relativity of Cost-Effectiveness

While China's cancer treatment costs rank low globally, “cost-effectiveness” requires comprehensive evaluation considering efficacy, patient experience, and equity. For early-stage patients, the Chinese model demonstrates “high efficiency at low cost”; for advanced-stage patients, access to innovative drugs and payment security remain gaps. With technological expansion and deepening payment reforms, China aims to raise five-year cancer survival rates to 46.6% by 2030 while keeping per capita treatment costs below 0.15% of GDP, truly achieving affordable, high-quality healthcare for all.

Document dated 2025-09-18 09:40 Modify