Economic Burden of Chemotherapy in Non-Hodgkin Lymphoma Patients under Indonesia’s National Health Insurance (JKN): A Cost of Illness Analysis in Samarinda

Non-Hodgkin lymphoma is a type of cancer affecting the lymphatic system, characterized by a high prevalence both globally and nationally. Chemotherapy is the primary treatment for this condition; however, it often imposes a substantial financial burden on patients. This study assessed chemotherapy-related costs incurred by patients diagnosed with non-Hodgkin lymphoma at a general hospital within the JKN Program for INA-CBG Regional 4 Tariff. Utilizing a descriptive observational design with a cross-sectional approach, the research was conducted retrospectively on 81 chemotherapy sessions that occurred in the second half of fiscal year 2024. Data were collected from medical records, payment receipts, and patient interviews. The findings revealed that total chemotherapy expenses reached Rp489,883,759, with an average cost of Rp6,154,302 per chemotherapy visit. The largest share of these costs was attributable to direct medical expenses, particularly cytostatic drugs, totaling Rp305,511,322. Additionally, direct non-medical costs totaled Rp 56,206,760, and indirect costs amounted to Rp 7,451,631. The drug incurring the highest cost burden was Rituximab 500 mg, with an average price of Rp8,250,750 per vial. Chemotherapy for patients with non-Hodgkin lymphoma imposes a significant economic burden, particularly for pharmaceuticals.