Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana has significantly improved timely access to cancer treatment for India’s poorest households, but current funding and benefit design fall far short of what is needed for comprehensive cancer care, a new study has warned. Drawing on FinCan modelling and government data, the analysis estimates that delivering a full five-year standard of care for cancer under the scheme would require about Rs 33,000 crore annually, compared with roughly Rs 7,700 crore currently allocated for cancer-related benefits. The authors argue that without expanded coverage, stronger emphasis on early diagnosis and redesigned benefit ceilings, India risks missing an opportunity to both save lives and reduce the economic burden of cancer on households.
The study underlines that Ayushman Bharat has become a lifeline for many oncology patients by easing financial barriers and speeding up treatment initiation. A related analysis published in The Lancet found that enrolment under the scheme increased the likelihood of starting cancer treatment within 30 days of diagnosis by about 90 per cent compared to pre-2018 levels, a shift the researchers link to insurance-enabled access to therapy. Government figures cited in the report indicate that since 2018, the programme has helped cover over 68 lakh cancer treatments worth around Rs 13,000 crore, with particular benefit for rural and low-income populations that previously struggled to access advanced therapies.
However, the FinCan team calculates that the cost of doing cancer care properly, including diagnostics, surgery, radiotherapy, targeted drugs and follow-up over a five-year period, is several times higher than what current allocations allow. Their models suggest that expediting diagnosis and treatment initiation within Ayushman Bharat could save about Rs 1,500 crore every year and result in roughly 1,560 additional survivors annually by reducing delays that push patients into late-stage disease. If India can expand screening to levels comparable with Organisation for Economic Co-operation and Development benchmarks, the study projects annual savings of around Rs 5,000 crore and more than 30,000 additional lives saved each year through earlier detection.
A central recommendation is to embed diagnostic coverage and organised screening into the core design of the scheme. Diagnostics currently account for only about 3 per cent of overall cancer care costs but often fall outside Ayushman Bharat packages, leading to delays in confirming a diagnosis and initiating treatment, the authors note. They propose integrating screening and diagnostic services through Health and Wellness Centres under the National Health Mission or incorporating them directly into AB-PMJAY benefit packages so that patients do not face out-of-pocket barriers at the front end of the care pathway.
The study also calls for a relook at the scheme’s financial ceilings for oncology, particularly for patients with advanced disease. It supports introducing a Rs 10 lakh top-up for high-stage cancers, targeting roughly 30 to 37 per cent of patients whose treatment is especially expensive, while allowing early-stage cases to remain viable under a revolving base cover. This approach, the authors argue, would align benefits more closely with real-world cost patterns, where a minority of patients drive a disproportionate share of expenditure due to intensive, multi-modality care.
Some policy movement is already underway. The Union Budget for 2025–26 earmarked funds to set up 200 new day care cancer centres in district hospitals, an initiative aimed at expanding access closer to home and bringing down out-of-pocket costs for travel and accommodation. Customs duties on several lifesaving cancer medicines have also been reduced or waived, which the study notes should help ease drug-related expenses for both the scheme and patients.
Summing up the implications, Dr Shankar, one of the experts associated with the analysis, said the challenge is “not only about spending more but also about spending smarter,” especially in areas like early diagnosis, diagnostics and long-term follow-up that can prevent late-stage suffering and catastrophic costs. With better-targeted investment and redesigned coverage, he argued, India can save more lives while reinforcing Ayushman Bharat’s role in delivering universal health coverage and financial protection against cancer.
