Abstract

Objectives

Cancer care in Ethiopia imposes a significant financial burden, with high direct costs (eg, treatment and hospital stays) and indirect costs (eg, lost productivity). Despite the growing cancer burden, comprehensive data on its economic impact and cost-effectiveness remain limited. This systematic review assesses the economic burden of cancer care and the cost-effectiveness of interventions in Ethiopia, focusing on both adult and pediatric cancers.

Methods

A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting Ethiopian-specific cost data, including direct and indirect costs, catastrophic health expenditure, and cost-effectiveness, were included. Economic evaluations and observational studies covering prevention to palliative care were considered. Cost data were standardized to 2019 values using the Campbell and Cochrane Economics Methods Group and the Evidence for Policy and Practice Information and Coordinating-Centre cost converter. Two independent reviewers’ extracted data, with quality assessment using the Consolidated Health Economic Evaluation Reporting Standards checklist.

Results

Of 656 identified records, 11 studies met the inclusion criteria. Cancer care costs were substantial, with medications, treatment, and hospital stays being the primary cost drivers. Lost productivity further exacerbated the burden. Pediatric oncology care and human papillomavirus vaccination were consistently cost-effective. Methodological approaches included decision trees, Markov models, and cost-effectiveness analyses. Gaps in uncertainty analysis, discount rates, and sensitivity analysis were noted.

Conclusions

Cancer care in Ethiopia remains a financial challenge, but cost-effective interventions, such as pediatric oncology programs and human papillomavirus vaccination, can mitigate costs. Strengthening financial protection mechanisms and conducting more detailed economic evaluations are crucial to informing policy and improving cancer care affordability.