Global Disparities: Can the World Afford Cancer?

Abstract

The last few decades have brought significant breakthroughs in the treatment of cancer, which have led to an improvement in the outcomes of patients worldwide. However, access to these treatments is limited for patients living in low-and-middle-income countries and in resource-limited settings of high-income countries. Despite the growing global burden of cancer, many healthcare systems are not well prepared to manage this epidemiological transition. This is an even greater issue in developing nations of the world, since only about 5% of the global resources for cancer control are spent in these countries. In this chapter, we review the reasons behind the high cost of cancer care and the barriers for accessing novel therapies, including the lack of government investment and the high cost of cancer medications. Additionally, we provide an overview of potential strategies to mitigate the high cost of cancer care, such as the achievement of universal health coverage, the use of compulsory licensing of cancer drugs, and the advent of generic and biosimilar medications. Finally, we suggest several approaches to increase the evidence base for reducing the cost of cancer drugs, including the utilization of biomarkers, the creation of resource-stratified guidelines and value-based models, and the design of studies aimed at optimizing the use of expensive medications.