Abstract
BackgroundMore alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region.MethodsWe 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. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund.ResultsOf 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” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region.ConclusionsThe availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’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.
Highlights
More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries
17.72 tab tablet, inj injectable, mg milligrams, ml milliliters, International unit (IU) international unit, n number of facilities surveyed and included in the analysis aAffordability is expressed as number of days needed to purchase 1 day of treatment based in minimum daily wage bAffordability in the private sector: we present only the affordability of the lowest priced generic medicines
Rituximab 100 mg/10 ml inj Rituximab 500 mg/50 ml inj Sorafenib 200 mg tab Sunitinib 12.5 mg tab Tamoxifen 20 mg tab Trastuzumab 440 mg inj Vincristine 1 mg inj Originator brand (OB) originator brand, Lowest Price Generic (LPG) lowest price generic, tab tablet, inj injectable, mg milligrams, ml milliliters, IU international unit, n number of facilities surveyed and included in the analysis, LATAMc Latin American countries, Median price ratio (MPR) median price ratio, Mex$ mexican peso, Management Sciences for Health (MSH) management sciences for health aMedian prices and MPR in the private sector: we present only the median prices and the MPR of the lowest priced generic medicines
Summary
More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Governments are facing a problem of limited affordability and availability of essential cancer medicines. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. The prices of many cancer medicines (both generic and originators) make them unaffordable for governments and patients, and contribute to their in health facilities in many low- and middle-income countries (LMIC) [4]. Equitable access to affordable essential medicines is a crucial component of comprehensive cancer care [3, 5,6,7]. Comparable information about access to cancer medicines is limited worldwide [10, 11]. Most studies have been limited to infectious diseases and medicines to treat non-communicable diseases (NCDs) other than cancer [14,15,16,17]
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