Ayushman Bharat: India’s flagship public health insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, has become a major support system for cancer patients by helping them access treatment that would otherwise be unaffordable, according to a recent study. But the report also says the money currently set aside for cancer care under the scheme still falls far short of what is actually needed.
The findings come from the FinCan study, carried out by a team of oncologists and health economists led by Dr Abhishek Shankar, Assistant Professor in the Department of Radiation Oncology at Dr B. R. Ambedkar Institute Rotary Cancer Hospital, AIIMS Delhi. The study looks at how AB-PMJAY has improved access to cancer care while also identifying areas where the scheme could be made more effective.
According to the researchers, the programme has significantly widened access to oncology treatment since its launch in 2018. Government data cited in the study shows that more than 68 lakh cancer treatments worth nearly Rs 13,000 crore have been covered under the scheme so far, with rural and lower-income patients among the biggest beneficiaries. The authors noted that targeted therapies made up an important part of that treatment support, marking a meaningful step in expanding modern cancer care.
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The study also pointed to earlier evidence published in The Lancet, which found that enrolment under AB-PMJAY increased the chances of starting cancer treatment within 30 days of diagnosis by around 90 per cent compared with the period before 2018.
At the same time, the FinCan study underlined the scale of the financial gap. It is estimated that providing full five-year standard cancer care, including diagnosis, surgery, radiotherapy, targeted drugs and follow-up, would require nearly Rs 33,000 crore every year. By contrast, the scheme currently allocates about Rs 7,700 crore annually for cancer treatment under its present package structure.
Dr Shankar said improving cancer care is not just about increasing spending, but also about using available funds more effectively. He said quicker diagnosis and faster treatment initiation could help India save around Rs 1,500 crore every year and lead to 1,560 additional survivors annually.
The study also found that if cancer is detected earlier through screening at levels comparable to OECD benchmarks, India could save nearly Rs 5,000 crore a year while also preventing more than 30,000 deaths annually.
Among the key recommendations in the report is a restructuring of how AB-PMJAY covers cancer costs. One suggestion is to replace the current annual cap of Rs 5 lakh per family with a five-year revolving ceiling of Rs 25 lakh. The idea is to allow patients to draw more support during the most expensive phase of treatment, usually in the first year, and use less in later years, so that care continues without interruption.
The researchers also proposed a Rs 10 lakh top-up for advanced-stage cancers, which would be aimed at the roughly 30 to 37 per cent of patients who need more expensive treatment. According to the study, patients diagnosed at an earlier stage may be adequately covered within the proposed revolving ceiling.
Another major issue flagged in the report is diagnostics. The study said diagnostic tests make up only about 3 per cent of total cancer treatment costs, but they are often not covered under the current structure of AB-PMJAY. That can delay treatment and weaken the benefits of insurance coverage. The authors recommended that screening and diagnostic support be built more firmly into the scheme, either through Health and Wellness Centres under the National Health Mission or by directly including them in AB-PMJAY packages.
Dr Shankar said some policy movement is already visible. In the Union Budget for 2025-26, the government announced plans to establish 200 new day care cancer centres in district hospitals, a move aimed at expanding access and reducing out-of-pocket spending. He also noted that customs duties on several life-saving cancer drugs had been reduced or removed, helping bring down the cost of treatment.
The study concludes that while AB-PMJAY has already improved access to cancer care, sped up treatment initiation and eased some of the financial pressure on patients, there is still considerable room to strengthen the programme. Better screening, stronger diagnostic support, improved benefit design and long-term treatment coverage, the report says, could help India save more lives while also reducing the economic burden cancer places on families.