The Cost of Mammograms in South Africa: Trends, Payment Options, and Accessibility

Cancer treatment can be tough and overwhelming, but it can also save lives. In South Africa, prostate cancer is a major concern for men, while breast cancer is the most common among women. Early detection and proper treatment are key to improving survival rates.

Mammograms are a powerful tool for catching breast cancer early, even before it can be felt. However, many South African women don’t have medical aid and rely on the public healthcare system, which often struggles to provide timely screenings. Even women with medical aid need referrals and may face extra costs for private mammograms, making access to these lifesaving tests a challenge.

Importance of Understanding Mammogram Costs

Mammograms are essential for detecting breast cancer early, helping to reduce illness and death. Regular screenings starting at age 40 can lead to early treatment. Skipping mammograms can result in larger tumours and lost years of life. However, many women face financial barriers, especially those with lower incomes, which can prevent them from getting screened.

The main obstacles to accessing mammograms include cost, lack of information, cultural fears, and convenience. In South Africa, mammogram costs vary depending on the type of insurance and whether co-insurance applies. It’s also important to consider other related expenses, like travel and time spent accessing healthcare, which can add to the financial burden.

Mammogram Costs in South Africa

The South African Optimal Care Group found that the average cost of a mammogram is around ZAR 2,000 in both private and public sectors, including the procedure and the radiologist report. However, this can vary by provider and medical aid funders, often leading to co-payments or extra fees.

In a survey of 165 patients in Johannesburg, most preferred paying ZAR 1,500 in cash after getting same-day results, rather than ZAR 2,000 through medical aid with a one-week wait for results. Government-run mammograms are subsidised based on income. At the time of the study, public breast clinics and academic institutions used donated or rented machines, with each machine being used about four times a week.

Factors Affecting Mammogram Costs

Mammogram prices vary based on who is paying. Medical aids reimburse providers, while the provider sets the fee for the service. Different radiologists may charge different rates, so costs can differ depending on the doctor and medical aid.

Payment Options

Many people pay for mammograms out of pocket. Those in prison or the military often get them for free, while some employers and organisations help cover costs. Around half of people pay using personal or family income, with 28.5% using private insurance, 18.6% relying on state facilities, and 7.5% receiving medical assistance. The uninsured population makes up over half, with private insurance rates staying around 25-28%.

Private Payment

Private payment is the standard for healthcare, with patients paying directly if medical aid doesn’t cover the service. Out-of-pocket costs are common for those without access to medical aid or employer-sponsored plans. In South Africa, private healthcare spending is rising, making up 4.3% of GDP by 2017. However, less than 7% of women use private facilities for mammograms, highlighting accessibility issues.

Medical Aid Coverage

Since 1999, medical aids have tightened control over high-cost diagnostic services like mammograms. They use provider networks and claim approval systems to manage costs. Radiology providers outside these networks are no longer covered, leaving patients to pay. Future reforms could change how medical aids cover cancer treatment, with ongoing discussions about National Health Insurance (NHI) and other policies.

Accessibility and Convenience

Access to mammograms is often limited by distance, especially for those in rural areas. Mobile mammography units have helped bring services closer to communities, but there are still fewer than 40 locations in South Africa for mammograms, even though it has the third-largest urban population in the world.

Radhiant’s Affordable and Accessible Services

Many nonprofits in urban areas offer low-cost mammograms and other screenings to women who can’t afford them. If a follow-up mammogram is needed, it’s also provided at a reduced rate. Patients are responsible for radiologist reports and doctor consultations. The goal is to make breast cancer screenings more accessible to underserved communities.

Radhiant Diagnostic Imaging is expanding its reach with mobile mammography units operating in smaller towns and rural areas, meeting the needs of people often left out of healthcare services. Many face barriers like low-paying, labour-intensive jobs, health issues, or financial obligations that prevent them from getting the care they need. The mobile service brings screenings directly to these communities in a regular, convenient way. Radhiant is registered with medical aid providers and charges no extra fees beyond what the provider covers. Their cash price of R1100 is lower than the industry average, making it more accessible to middle-income earners. However, this is still too expensive for many low-income families, and Radhiant is working on partnerships to lower these costs, with the long-term goal of offering free or low-cost mammograms to those in need.

Radhiant’s Friendly and Professional Patient Care 

Many women delay scheduling a mammogram due to fears about discomfort or the perception that the procedure is invasive and or feeling uneasy about the process itself. One of our most asked question is “are mammograms painful?”. However, it’s important to remember that modern mammograms are designed to be quick, with minimal discomfort, and play a crucial role in detecting breast cancer early. The Radhiant team prides itself on its mindful, caring and friendly patient care that works to ensure our patients are comfortable and well looked after at every appointment.

Mobile Mammography Trucks and Vans

Mobile mammography vans have been successfully used in campaigns to bring breast screening services to both urban and rural areas, raising awareness about early cancer detection and risk prevention. These vans make it easier for people in remote regions to access mammograms, but they can only stay in one area for a limited time. The Department of Health recommends mammograms every two years for women aged 50 to 65, and screenings based on individual need for those over 65, so annual screenings via mobile units aren’t always possible. Focusing on women needing follow-up tests ensures the best use of these resources.

Mobile units help address the long wait times for mammograms, especially during peak periods, by offering faster access. Radhiant’s mobile mammography van, launched in 2023, aims to meet public demand. It’s a self-powered, state-of-the-art facility that doesn’t rely on grid power. The van uses digital imaging technology that adjusts for breast thickness and minimises radiation exposure while delivering high-quality images with immediate results for the radiologist. This setup ensures timely, efficient screenings and faster diagnosis.

Conclusion

In conclusion, this article highlights the growing availability of mammography services across South Africa, reflecting increased efforts to manage costs in both public and private sectors. Each year, around 500,000 mammograms are done in the country, with 420,000 of them in the private sector. Setting up digital mammography units typically costs around ZAR 3.5 million, with a range between ZAR 1.5 million and ZAR 6 million. The cost of essential machinery makes up more than a third of these expenses, and reducing these costs is key to increasing access and improving service capacity. High costs remain a major barrier, making policy changes essential to improve accessibility. Learning from other countries, South Africa could implement varied pricing and equipment-sharing models to boost access, particularly for older women, which could help improve breast cancer survival rates.

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