Abstract
BackgroundCancer has become the third cause of death in Mexico. Treatment for cancer is often complex and lengthy. New and better medicines enter the market at high prices, which may limit access. Like most Latin American countries, Mexico has an essential cancer medicines list that includes innovative medicines. Their accessibility and use in the public sector remains unknown. Therefore, we describe the use, as a proxy of access, of innovative and essential cancer medicines in the public sector in Mexico, by insurance institution, and by five regions between 2010 to 2016.MethodsWe used drug utilization research methods to assess the use of eight patented cancer medicines. Through the national transparency platform, we obtained data on the quantities of these medicines used in all public health facilities and social health insurance institutions and recalculated those figures into defined daily dose (DDD) per 1000 population per year.ResultsOverall, the use of all medicines increased over the years, especially for trastuzumab, rituximab and imatinib. The use of innovative medicines was higher per population covered in social health insurance institutions than in governmental facilities. Throughout the study period, the Central region (including Mexico City) has used more medicines per population than the other regions.ConclusionsThe use and access of some essential innovative cancer medicines has increased over the years, but remains unequal across insurance schemes and regions. Particularly, the Ministry of Health Insurance scheme and Northern and Western regions in the country would benefit from additional efforts to increase access to essential cancer medicines.
Highlights
Cancer has become the third cause of death in Mexico
The quantities of rituximab and imatinib have remained high throughout the years, while trastuzumab shows a considerable increase since 2012 and a decrease between 2015 and 2016
Mexican Social Security Institute (IMSS) procured the largest volume of medicines, but when adjusted to quantities procured per population covered, it has the lowest rates among the five social health insurance (SHI) institutions
Summary
Cancer has become the third cause of death in Mexico. Treatment for cancer is often complex and lengthy. Like most Latin American countries, Mexico has an essential cancer medicines list that includes innovative medicines. Their accessibility and use in the public sector remains unknown. We describe the use, as a proxy of access, of innovative and essential cancer medicines in the public sector in Mexico, by insurance institution, and by five regions between 2010 to 2016. Cancer has become a leading cause of disability and mortality in the world, in low and middle-income countries (LMIC) [1,2,3] Such health care systems are not yet prepared to handle this burden [4]. This sector consists of five different social health insurance (SHI) institutions, each with their independent facilities and managerial styles, responsible for providing health coverage and care
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