Economic Burden of Pediatric Oncology Care in Developing Countries: A Systematic Review

Abstract Pediatric oncology care in developing countries poses considerable economic challenges due to high direct medical, direct nonmedical, and indirect costs related to childhood cancer treatment. Families often face catastrophic financial burdens, which impact treatment adherence and outcomes. This article summarizes and analyzes the economic burden of pediatric oncology care on families and health systems in developing countries. A systematic review of studies from low- and middle-income countries was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing six major databases (PubMed, ScienceDirect, Cochrane Library, Lippincott Home, Sage Journals, and Google Scholar) to identify relevant studies published from 2015 until 2025. The Population, Intervention, Comparison, and Outcomes (PICO) framework was applied alongside specific keywords to select studies relevant to the research topic. Findings show that families bear substantial out-of-pocket expenses, including treatment, transportation, accommodation, and lost income, often exceeding their financial capacity. Health financing systems are often inadequate, leading to high treatment abandonment rates. Access to insurance and financial support programs reduces economic hardship and improved treatment continuity. Cost-effectiveness analyses demonstrate that investing in pediatric oncology care yields substantial health and economic benefits, with the cost per disability-adjusted life year averted typically falling below one times the country's gross domestic product per capita. The economic burden of pediatric oncology care in developing countries is profound and multidimensional, necessitating strengthened health financing, expanded insurance coverage, and social support programs to improve access and reduce financial toxicity for affected families.