Abstract
Background: Cancer poses a serious threat to one’s health, which caused significant economic burden on the family and society. Poor availability and affordability resulted in some essential medicines failing to meet the basic health needs of this group of patients. The objective of this study was to evaluate the availability, prices and affordability of 32 anticancer essential medicines in Hubei Province, China. Methods: Data on the availability and price related information of 32 essential anticancer medicines in the capital and five other cities of Hubei Province were collected. A total of 28 hospitals were sampled, which included 13 tertiary hospitals and 15 secondary hospitals. We used the standard methods developed by the World Health Organization and Health Action International to compare the differences in drug price, availability and affordability between secondary hospitals and tertiary hospitals. Results: Overall, the availability of medicine was higher in tertiary hospitals. The average availability of originator brand (OBs) was 13.70% (tertiary hospitals) VS 6.67% (secondary hospitals), and lowest-priced generic (LPGs) was 62.83% (tertiary hospitals) VS 42.92% (secondary hospitals). The MPR value of most sampled medicines in secondary hospitals were less than 1. In contrast, the MPR of Cytarabine (17.15), Oxaliplatin (12.73) were significantly higher than the international reference price. The top three OBs’ total expenses for 30-days treatment were Irinotecan, Oxaliplatin, Bicalutamide. Further, their affordability was relative low, as the costs for one course using these medicines were much higher than 20% of the minimum family monthly income. Conclusion: Though the “Zero Mark-Up” and “Centralized procurement policy of anti-tumor drugs” policies have been implemented in China, the availability issue yet to be addressed. High price and low affordability were the major barriers to the access of essential anticancer medicines. Measures should be taken to provide sufficient, available and affordable medicines to patients in need.
Highlights
Cancer has become a serious health problem, which contributed to severe burden of disease and even death (Zhu et al, 2019)
High price and low affordability were the major barriers to the access of Abbreviations: HAI, Health Action International; WHO, World Health Organization; EML, Essential Medicine List; OB, Originator Brand; LPG, Lowest Priced Generic; NEML, National Essential Medicine List
We calculated the availability of originator brands (OBs) and lowest priced generics (LPGs) across the 32 anticancer medicines
Summary
Cancer has become a serious health problem, which contributed to severe burden of disease and even death (Zhu et al, 2019). Anticancer medicine is a core component of treatment, but barriers to receiving cancer therapy such as high price of anticancer medicines and poor availability were yet to be solved (Smith et al, 2014). These problems may be related to medical information asymmetry and the distribution of responsibilities between the drug purchasing sector and the patients who bear the cost restrict competition in the market (Hasan et al, 2019). Essential medicines are the indispensable drugs that satisfy the priority health care needs of the population. The objective of this study was to evaluate the availability, prices and affordability of 32 anticancer essential medicines in Hubei Province, China
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