The Oncology Price Book

THB 348,000 buys a total mastectomy with sentinel-node biopsy and axillary dissection at Bangkok Cancer Hospital, four nights of inpatient stay included, on a schedule the hospital has published and dated valid until 31 December 2026. About US$10,413 at the October 2026 rate. It is a real number on a public page, checkable by anyone with a browser, quoted to the thousand baht. It is also, on the evidence of every hospital page checked for this book, the only part of a course of cancer treatment in Southeast Asia that has a published price at all.

What follows is a treatment-line price book assembled from the two primary sources that exist: one hospital’s own published schedule, and one peer-reviewed costing study of nine Philippine tertiary hospitals. Every figure in it is what one page or one study published on one date; what a particular course costs is a question only the hospital and the treating oncologist can answer. The companion file on what an ischaemic stroke or a cardiac event costs the uninsured expat prices an acute event with a beginning and an end. Cancer has neither, and that turns out to be the whole finding.

The schedule that prices the operation

The Bangkok Cancer Hospital surgery packages page lists eight breast procedures with a length of stay attached to each. Lumpectomy with sentinel lymph node biopsy under general anaesthetic, two nights, THB 266,000. The same operation with axillary dissection, four nights, THB 308,000. Modified radical mastectomy, four nights, THB 310,000. Total mastectomy with sentinel-node biopsy and axillary dissection, four nights, THB 348,000. Needle localisation under general anaesthetic, one night, THB 135,000, or THB 144,000 by stereotactic guide. Lymphovenous anastomosis for one or two spots, two nights, THB 322,000.

Three sentences of terms sit under the table. “The Package Price applies to Fly in.” “These prices are valid until 31 December 2026.” “The hospital hold the right to change the price without prior notice.”

Read the first one again. The published price is attached to a patient category, the medical traveller who arrives for the procedure, and a Western retiree already living on a one-year extension in Chiang Mai is not obviously inside it. The page does not say what he is quoted instead. No hospital is obliged to publish anything, and this one publishes more than almost any other in the region. The question here is narrower: what the number can be relied on to mean for the reader holding it.

Where the schedule stops

Surgery is where it stops. Checked again on 18 October 2026, the Bangkok Cancer Hospital package index carries early-detection and screening packages (a low-dose chest CT from THB 6,900, male and female detection panels) and the surgery schedule above. There is no chemotherapy package price. No radiotherapy course price. No targeted-therapy or immunotherapy line of any kind. Bumrungrad International’s package pages, checked the same day, do price cancer operations: a unilateral mastectomy with sentinel-node biopsy at THB 335,800 for two nights, a robotic radical prostatectomy at THB 1,014,000. The nearest thing to a drug line is a single transarterial chemoembolisation of a liver tumour at THB 220,900, which is itself a procedure with a start and an end. No chemotherapy course. No radiotherapy course. No immunotherapy.

The Philippine side is quieter still. St Luke’s Medical Center’s Department of Radiation Oncology publishes a detailed clinical page: two linear accelerators, a high-dose-rate brachytherapy machine, and eleven named modalities from conventional radiotherapy through IMRT, SBRT, image-guided brachytherapy and respiratory gating. Eleven techniques described. Zero prices.

Into that silence comes the medical-tourism aggregator layer, which quotes chemotherapy in Thailand from US$1,000, breast-cancer chemotherapy at US$5,000 to 9,500, leukaemia at US$7,500 to 16,500. No regimen. No cycle count. No hospital-specific figure and no validity date on any of it. A from-price, or a range that doubles across its own width, with no unit attached is a lead-generation device — a patient cannot plan against it, and cannot refuse it either, because nothing else is on offer.

The Philippine numbers exist, and they were costed for someone else

They exist in the literature rather than on a hospital page. A 2025 financing cost assessment study in Acta Medica Philippina costed breast cancer treatment bottom-up across nine tertiary hospitals, seven government and two private, all of them accredited by PhilHealth to deliver the Z Benefit Package. Data were collected in 2022 at 2021 prices.

The study prices what the hospitals do not. Modified radical mastectomy at a private hospital, median PHP 222,832.61; at a government hospital, PHP 200,000 to 250,000. Total mastectomy private, PHP 375,825.24. Lumpectomy, PHP 99,735.22. Chemotherapy drugs, and this is drug acquisition cost only with administration and professional fees counted separately, PHP 596.70 to 3,700.00 per cycle. Trastuzumab, PHP 46,394.21 per cycle. Conventional radiotherapy “can cost up to PhP 88,150.00 covering 28 sessions, CT simulation, and CT planning”. Hormone therapy from PHP 3,276 a year for tamoxifen to PHP 68,284 for goserelin.

Note the setting. Every one of those nine hospitals is inside the scheme a foreign national is barred from. The costing exercise was done to price a benefit package, and the benefit package is not his.

The price book

Six lines make up a course of treatment. One of them has a published price at named regional hospitals. The other five do not, and the five include everything that happens after the patient leaves the ward.

Where a course of treatment actually goes

The same Philippine study models a full course end to end. Stage 2B triple-positive breast cancer runs PHP 1,644,947.48 for a premenopausal patient and PHP 1,792,187.35 post-menopausally, or US$26,124 to $28,462. Chemotherapy plus targeted therapy is roughly PHP 1.2 million of that, 70 to 75% of the total. Eighteen sessions of trastuzumab alone the authors put at PHP 835,095.96.

Set each line against the study’s own low-end total and the shape is not what the price book implies.

The rust bar is the priced one. Thirteen and a half per cent.

There is a reason the ratio runs that way, and it is not commercial. Surgery is a bounded event. It has a start, an end, a night count, a discharge summary, and it can therefore be sold as a package with a number on it. Chemotherapy, radiotherapy and targeted therapy are not events; they are durations, priced per cycle and per fraction, with the cycle count set by a pathology report that does not exist on the day the patient asks what this will cost. A price is a promise that something will finish. The lines nobody publishes are the lines nobody can promise will finish, and those are the lines that hold half the money.

Thailand’s own health-technology assessment says the same thing from the payer’s side. A 2026 cost-utility study of biosimilar trastuzumab in HER2-positive metastatic breast cancer put the incremental cost per quality-adjusted life year at THB 195,541 for a one-year regimen and THB 231,119 for continuous treatment, against a national threshold of THB 160,000. The authors calculate the drug would need to fall to about THB 3,700 a vial to clear it. The most expensive line in the treatment is the one the state’s own arithmetic declines to pay full price for.

The nationality line

The Philippines is the one country in the region that lets a foreign retiree into its public health insurer at all, which is why what PhilHealth actually covers a foreigner is worth reading before the diagnosis rather than after it. He pays the premium, he holds the card, he draws ordinary inpatient and outpatient case rates.

Then the 2017 coverage notice that admitted him names what he does not get: “Excluded from their entitlements, however, are the Z Benefit packages, reimbursement for all confinements abroad and benefits for women about to give birth.”

The Z packages are the catastrophic tier. Since 30 March 2024 the breast cancer package has been worth up to PHP 1.4 million, and PhilHealth’s own breakdown puts the bulk of it, “more than Php 1 million coverage”, in the targeted-therapy line, precisely the 50.8% bar. Surgery in the package runs PHP 30,000 to 140,000; cytotoxic chemotherapy PHP 43,000 to 185,010; hormonotherapy PHP 2,700 or 18,000.

Put the package against the course. A Filipino woman treated for stage IIB triple-positive disease at one of those nine accredited hospitals faces PHP 1,644,947.48 and can draw up to PHP 1,400,000 of it, leaving a residual of PHP 244,947.48, about US$3,890. A foreign national with the same disease, at the same hospital, holding the same card, draws PHP 0 from that tier. The differential on one line of one bill is up to PHP 1,400,000 — around 85% of the course, decided by nationality.

What the same bill looks like from four sides

Twelve months, and the joint distribution

Cost pieces usually end on a mean. The better closing statistic for this one is a joint distribution, and it exists.

The ACTION study recruited 9,513 consecutively enrolled adults with newly diagnosed cancer across eight ASEAN countries (Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Thailand, Vietnam) between March 2012 and September 2013, and followed them for twelve months. Of the 6,787 with complete outcome data, 29% had died. Forty-eight per cent had experienced financial catastrophe, defined as out-of-pocket medical costs above 30% of annual household income. And 23% were alive with no financial catastrophe.

Twenty-three per cent. That is the figure to hold, because it is the only one of the three that describes the outcome anyone was hoping for. Patients without health insurance carried higher odds of both endpoints: 1.27 for financial catastrophe, 1.51 for death. Insurance protected against financial catastrophe in the upper-middle-income countries, Malaysia and Thailand, and did not in the lower-middle-income ones, which the authors attribute to the limits of the benefit packages on offer there.

This cohort is local households, in 2012 and 2013, at incomes far below a Western pension. No study has measured the twelve-month joint outcome distribution for Western expatriates diagnosed with cancer in Southeast Asia; that number does not exist, and 48% is not a retiree’s probability of ruin. What transfers is the structure. At twelve months, death and financial catastrophe are competing outcomes rather than sequential ones. The patient does not get ruined and then die; he is sorted into one bin, or the other, or both. The variable doing the sorting is whether a catastrophic scheme stood behind the unpriced lines. For the foreign retiree in either country, nothing does.

Where this book is thin

Four limits, and they are load-bearing.

The Thai schedule is breast surgery only, and the page attaches it to fly-in patients, so it may not describe what a resident is quoted. The Philippine figures are 2021 prices from a 2022 collection, converted at an October 2026 exchange rate; the peso price has not been re-based for five years of medical inflation and the dollar column mixes vintages in both directions. Both datasets cover breast cancer, the disease with the best-developed costing literature in the region, and nothing here prices lung, colorectal, prostate or haematological disease. And neither was assembled for a foreign self-payer.

The last one cuts deepest. Every price in this book was published or costed for somebody else: a medical traveller flying in for one operation, or a Filipino patient inside a benefit package that names foreign nationals as excluded. Nobody has written a price book for the Western retiree who is neither. That is why he cannot find one, and why what he finds instead is a range.

There is also the question this book cannot reach at all. What happens when treatment stops working, in a region where palliative and hospice provision is thin and unevenly distributed, has its own unpriced schedule. Stage at diagnosis sets how soon that page is turned, and stage is largely set by whether anyone was screening him.

The schedule expires on 31 December 2026

The most honest line on the Bangkok Cancer Hospital page is the one nobody reads: these prices are valid until 31 December 2026, and the hospital may change them without notice. A published price is a promise with an end date on it. The disease does not have one, the trastuzumab does not have one, and the eighteenth cycle costs what it costs on the day it is hung.

A price book you can check is worth more than a range you cannot. This one covers an eighth of the bill. The rest is a number the patient learns one cycle at a time — in a currency he does not earn, on a course of treatment that quotes itself as it goes.