{"entity":{"id":"paper-kimman-action-catastrophic-expenditure-southeast-asia-bmc-med-2015","kind":"paper","name":"Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries","aka":["ACTION study"],"tldr":"The ACTION study followed 9,513 adults with newly diagnosed cancer in eight Southeast Asian countries for a year: across all eight, 29% had died and 48% faced costs above 30% of household income, so only 23% were alive without financial catastrophe. Malaysia's cancer plan cites it.","summary":"The ASEAN Costs in Oncology (ACTION) study, started in 2012, prospectively recruited 9,513 consecutive adults with a first diagnosis of cancer in the Association of Southeast Asian Nations region. Twelve months after diagnosis it recorded deaths and household financial catastrophe, defined as out-of-pocket medical costs above 30% of annual household income, and modelled their predictors.\n\nMalaysia's National Strategic Plan for Cancer Control Programme 2021-2025 cites this study for its statement that about 45% of Malaysian cancer survivors spend over a third of household income on cancer care in the first year after diagnosis; that country figure is the plan's, and is not in the paper's abstract.","asOf":"2026-11-04","links":[{"label":"BMC Medicine 2015","url":"https://doi.org/10.1186/s12916-015-0433-1"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/26282128/"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["ministry-of-health-malaysia","protecthealth-malaysia"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"BMC Medicine","year":2015,"doi":"10.1186/s12916-015-0433-1","pmid":"26282128","authors":"Kimman M, Jan S, Yip CH, et al.","paperType":"observational","findings":["A year after diagnosis 29% had died, 48% had faced financial catastrophe and 23% were alive with no financial catastrophe.","Participants in the lowest income group had higher odds of financial catastrophe (odds ratio 5.86, 95% CI 4.76 to 7.23) and of death (5.52, 4.34 to 7.02) than those with high income.","People without insurance were more likely to face financial catastrophe (1.27, 1.05 to 1.52) and to die (1.51, 1.21 to 1.88)."],"whatItMeans":"Cost and survival are linked in the region: a later stage at diagnosis and a lower income each raised the chance of both outcomes, which is the case Malaysia's cancer plan makes for financial protection and earlier diagnosis.","caveats":["The pooled results cover eight countries; the abstract gives no Malaysia-only figure."],"participants":9513},"route":"/key-papers/paper-kimman-action-catastrophic-expenditure-southeast-asia-bmc-med-2015/","neighbours":{"institution":[{"id":"ministry-of-health-malaysia","kind":"institution","name":"Ministry of Health Malaysia","route":"/institutions/ministry-of-health-malaysia/"},{"id":"protecthealth-malaysia","kind":"institution","name":"ProtectHealth Corporation","route":"/institutions/protecthealth-malaysia/"}]}}