Cost of Delivering National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke Services in the Primary Level of Health Care in Puducherry District of India

Background: Strengthening primary health care for noncommunicable diseases (NCDs) under Ayushman Bharat requires information on the cost of delivering the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) services in the Health and Wellness Center (HWC). Therefore, we aimed to determine the total annual and unit cost of delivering NPCDCS services at the public sector’s primary level of health care. Methodology: Economic costing of Sub-Health Center (SHC) and Primary Health Center (PHC) upgraded to HWC was conducted from the health system perspective. A bottom-up microcosting methodology was adopted to collect and analyze data on resources utilized for delivering healthcare services. Joint resources were apportioned, and sensitivity analyses were performed on total annual costs. Results: The total annual cost of delivering NPCDCS services was ₹58,662 and ₹1,249,234 at selected SHC and PHC, respectively. Unit cost per NCD beneficiary was ₹438 and ₹661, and unit cost per outpatient attendance was ₹335 and ₹85 at SHC and PHC, respectively. Promotive services accounted for 6% and 40% of the total annual cost at SHC and PHC, respectively. Conclusion: The study findings can be used to efficiently and effectively allocate resources toward NCD care in the HWCs.