Navigating the completing cancer treatment incentive in Malaysia: patient insights and implementation challenges

BACKGROUND: Cancer diagnosis imposes a significant economic burden on healthcare systems, patients, and their families particularly those from low-income households. To mitigate these challenges, Malaysia introduced the completing cancer treatment incentive (CCTI) under the PeKa B40 healthcare scheme to support cancer patients in completing their treatment. This study explores patients' experiences with the CCTI program to provide insights for refining policy interventions and enhancing the program's effectiveness in meeting the needs of its beneficiaries.

METHODS: This qualitative study examined the experiences of cancer patients with the CCTI program in Malaysia. Semi-structured interviews were conducted with 23 respondents, both CCTI recipients and non-applicants, from eight public hospitals. Data were anlaysed using the RE-AIM framework, focusing on the dimensions of reach, adoption, and implementation.

RESULTS: Patients' awareness of the CCTI varied, with recipients mostly informed through acquaintances, media, or healthcare providers. Non-recipients lacked awareness, with limited information provided by healthcare personnel. While the CCTI was perceived as valuable for alleviating financial burdens, particularly transportation costs, it did not appear to significantly influence treatment-seeking behaviours, as most patients expressed willingness to continue treatment even without financial aid. Implementation challenges included a burdensome application process requiring mandatory health screening, lack of clarity regarding procedures, and inadequate communication about claim approvals. Patients frequently encountered delays and confusion, exacerbated by insufficient support from healthcare providers. Additionally, many were unaware that transport incentives could be claimed for every hospital visit, further limiting the program's usefulness.

CONCLUSIONS: The study highlights critical gaps in the CCTI program's design and delivery, including inadequate communication strategies, complex administrative processes, and a lack of transparency. Addressing these challenges are essential to improve program reach and ensuring equitable access to CCTI. Policymakers should prioritise streamlining application process, enhancing information dissemination, and leveraging digital tools to improve patient experiences. Future studies should assess the program's long-term sustainability and impact on treatment adherence and outcomes. The findings underscore the importance of adopting patient-centred approaches in designing financial aid programs to enhance healthcare equity and access.