Abstract
BackgroundPrices of cancer medicines are a major contributor to the cost of treatment for cancer patients and the comparison of these cost needs to be assessed.ObjectivesTo assess the prices of cancer medicines for the three most common cancers ((breast, prostate and colorectal) in the private healthcare sector of South Africa.MethodsThe methodology was adapted from the World Health Organization (WHO)/ Health Action International (HAI) methodology for measuring medicine prices. The Single Exit Price (SEP) variations between product types of the same medicine between the highest- and lowest-priced product and between Originator Brand (OB) and its Lowest Priced Generic (LPG) of the same medicine brand was compared, as of March 2020. The affordability of those medicines for cancer usage based on treatment affordability in relation to the daily wage of the unskilled Lowest-Paid Government Worker (LPGW) was also determined. Also, a comparison of the proportion of the population below the poverty line (PL) before (Ipre) and after (Ipost) procurement of the cancer medicines was determined.ResultsSEP Price differences ranged from 25.46 to 97.33% between highest- and lowest-priced products and a price variation of 72.09% more for the OB than the LPG medicine, except for one LPG that was more expensive than the OB. Affordability calculations showed that All OB treatments for all three cancers (breast, prostate and colorectal), except for paclitaxel 300 mg (0.2 days wage) and Fluorouracil (Fluroblastin) 500 mg (0.3 days wage) costs respectively were more than 1 day’s wage, with patients diagnosed with colorectal cancer needing 32.5 days wages in order to afford a standard course of treatment for a month.ConclusionThere was a considerable variation in the price of different brands of cancer medicines available in the South African private sector.
Highlights
The global cancer burden is estimated to have risen to 18.1 million new cases and is responsible for an estimated 9.6 million deaths in 2018 [1]
The price variability between the Originator Brand (OB) and Lowest Priced Generic (LPG) for 66.7% of the medicines analysed was over 50%, this means that when OB medicines are prescribed/dispensed in the private sector, patients pay over 50% more than they would for generics
The results of this study suggest that oncology medicine prices in South Africa are still high, and there are large price differences in the private sector between highest-priced and their lowest-priced equivalents, as well as between OB and LPG
Summary
The global cancer burden is estimated to have risen to 18.1 million new cases and is responsible for an estimated 9.6 million deaths in 2018 [1]. About 1 in 6 deaths is due to cancer. About 70% of deaths from cancer occur in Low-and Middle-Income countries (LMICs) [1]. In South Africa, the estimated cancer cases are 107,464 in 2018 and may increase to 177,773 in 2040 [2]. In South Africa, breast, prostrate and colo-rectal cancer rank in the top 10 cancers with cases of 15,491, 13,152 and 7354 respectively in 2020 [2, 3]. It is known that early detection and treatment may improve health outcomes associated with the disease for adults [1] and this would depend on the equitable access to available and affordable low cost highly active cancer medicines. Prices of cancer medicines are a major contributor to the cost of treatment for cancer patients and the comparison of these cost needs to be assessed
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