Cancer type & staging

Cancer type

TNM stage

ECOG performance status

Comorbidity index (CCI)

Treatment modalities

Chemo cycles 6

Radiation sessions 0

Surgery (major=1) No

Targeted / immunotherapy

G-CSF prophylaxis

Cost breakdown

Chemotherapy drugs—

Oncologist fees—

Infusion / day care—

Radiology & imaging—

Lab & pathology—

Radiation therapy—

Surgery & anaesthesia—

Targeted / immunotherapy—

Supportive care & G-CSF—

Overhead (15% ABC)—

Episode bundle cost (DRG-weighted)

RM 0

DRG code

—

DRG weight

—

Base rate (MYR)

RM 8,400

Episode duration

—

Suggested insurance tariff (+22% margin)

RM 0

Oncology DRG reference — Malaysian private sector calibrated

Base rate: MYR 8,400 per DRG unit. Weights calibrated against MOH casemix data and private hospital tariff benchmarks. ML adjustment applied for ECOG ≥2 and CCI ≥3.

Scenario comparison — insurance negotiation view

Selected scenario breakdown

Clinic P&L — monthly oncology revenue model

New cases/month 10

% insured patients 65%

Avg bundle tariff (RM) RM 55k

Avg bundle cost (RM) RM 45k

Monthly revenue waterfall (RM)

Annual projection

I-DRG Oncology Bundle Costing