Pricing appraisal of anti-cancer drugs in the South East Asian, Western Pacific and East Mediterranean Region

Shahrzad Salmasi,Chin Fen Neoh,Long Chiau Ming,Zaheer-Ud- Din Babar,Mahmoud E Elrggal,Kah Seng Lee,Muhammad Abdul Hadi,Tahir Mehmood Khan

doi:10.1186/s12885-017-3888-y

Abstract

BackgroundGlobally, cancer is one of the leading causes of mortality. High treatment cost, partly owing to higher prices of anti-cancer drugs, presents a significant burden on patients and healthcare systems. The aim of the present study was to survey and compare retail prices of anti-cancer drugs between high, middle and low income countries in the South-East Asia, Western Pacific and Eastern Mediterranean regions.MethodsCross-sectional survey design was used for the present study. Pricing data from ten counties including one from South-East Asia, two from Western Pacific and seven from Eastern Mediterranean regions were used in this study. Purchasing power parity (PPP)-adjusted mean unit prices for 26 anti-cancer drug presentations (similar pharmaceutical form, strength, and pack size) were used to compare prices of anti-cancer drugs across three regions. A structured form was used to extract relevant data. Data were entered and analysed using Microsoft Excel®.ResultsOverall, Taiwan had the lowest mean unit prices while Oman had the highest prices. Six (23.1%) and nine (34.6%) drug presentations had a mean unit price below US$100 and between US$100 and US$500 respectively. Eight drug presentations (30.7%) had a mean unit price of more than US$1000 including cabazitaxel with a mean unit price of $17,304.9/vial. There was a direct relationship between income category of the countries and their mean unit price; low-income countries had lower mean unit prices. The average PPP-adjusted unit prices for countries based on their income level were as follows: low middle-income countries (LMICs): US$814.07; high middle income countries (HMICs): US$1150.63; and high income countries (HICs): US$1148.19.ConclusionsThere is a great variation in pricing of anticancer drugs in selected countires and within their respective regions. These findings will allow policy makers to compare prices of anti-cancer agents with neighbouring countries and develop policies to ensure accessibility and affordability of anti-cancer drugs.

Highlights

Cancer is one of the leading causes of mortality
Located in the South-East Asian, Western Pacific or Eastern Mediterranean regions
Based on the inclusion criteria, Thailand was the only eligible country from South-East Asia, Malaysia and Taiwan were included from the Western Pacific, and Oman, Pakistan, the United Arab Emirates, Lebanon, Egypt, Saudi Arabia and Bahrain from the Eastern Mediterranean region

Summary

Introduction

Cancer is one of the leading causes of mortality. High treatment cost, partly owing to higher prices of anti-cancer drugs, presents a significant burden on patients and healthcare systems. With the exception of a few high-income countries such as Israel, Kuwait, Qatar, the Republic of Korea, Singapore, and the United Arab Emirates who enjoy well-developed health services, the vast majority of the Asian people face a substantial cancer burden because cancer care remains a low priority in healthcare planning and expenditure [4]. In these countries, over 60% of the total healthcare expenditure comes from private resources, of which more than 80% is direct out of pocket payments, with catastrophic results for most families in these countries [4]. The cancer drug expenditure as a percentage of total drug expenditure is very low in Middle Eastern countries [6]

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