Cancer Medicine Prices in Low- and Middle-Income Countries
According to the World Health Organization (WHO), cancer is one of the leading causes of death worldwide; in 2008, it accounted for approximately 7.6 million deaths (13 percent of all causes of death). More than 70 percent of all cancer deaths occurred in low- and middle- income countries (LMICs). While it is estimated that more than 30 percent of deaths can be prevented through early detection and modifying or avoiding key risk factors, the demand for cancer treatment, especially in low-income countries, is not being adequately met. High cost and poor availability of cancer treatment are significant barriers to access in many LMICs. In Pakistan, which has a per capita income of 2,860 US dollars (USD), the cost of treating leukemia with chemotherapy and associated transfusion requirements is USD 20,000. Although the cost of medicines for palliative care at the supplier level does not represent a substantial barrier to access, retail prices can be a major deterrent to access as they can be prohibitive.
Ensuring affordable access to quality cancer medicines, vaccines, and related health techno- logies depends not only on wise selection by national authorities, but also on price reduction and procurement strategies appropriate to each type of product. If essential medicines for cancer are listed in a country’s national essential medicines list (NEML) and linked to standard treatment guidelines, selection and procurement become easier and can contribute to lower prices. For example, antihypertensive medicines are cheaper in the public sector when listed in an NEML.
Procurement officers often do not have easy access to available pricing information to make the best purchase decisions for public health programs. Transparent, web-based exchange of information on prices and sources of cancer medicines and vaccines should be expanded. Such information can achieve dramatic price reductions –especially on off-patent products– when used in competitively pooled procurement by reliable global, regional, or national procurement and supply organizations.