Availability, Prices and Affordability of Selected Essential Cancer Medicines in a Middle-Income Country: The Case of Mexico

Abstract

Background: More alternatives are becoming available for the diagnosis and treatment of cancer in low- and middle-income countries. Yet, because of increasing demands, many governments are now facing the dilemma of making essential cancer medicines available to all while keeping them affordable. Precise information about current access to these medicines is limited, and there's no systematic methodology in place to do so. Aim: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices (public sector procurement and patient prices) against those in other countries of the region. Methods: We adapted the WHO/HAI methodology. We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines (each strength and dose-form specific). Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People's Health Insurance” (SPS) were slightly more available. Only 7 (public sector) and 5 (private sector) out of 49 medicines were deemed affordable. Overall, public sector procurement prices were 41% lower than in other countries of the region. Conclusion: The availability of essential cancer medicines, in the public and private sector, falls below WHO's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.