Access To Cancer Drugs Should Be Transparent

Armen Hareyan's picture

Almost one person in three has no access to full and effective cancer treatment with the medicines they need - in the poorest parts of the world, this rises to more than one in two. Even in highly developed countries, access to the best cancer therapy is not guaranteed for all.

Cancer drugs account for 10-20% of spending on cancer care. Sales of cancer drugs reached $34.6 billion in 2006, up 20.5% on 2005.

UICC board of directors takes a position

At its meeting in November, the UICC board of directors adopted a position paper on access to cancer drugs. The paper is intended to stimulate discussion on ways of promoting more equitable access to optimal cancer care worldwide.

Many countries cannot afford the high price of patent-protected cancer drugs, the board says. Patent enforcement by pharmaceutical companies in low-income countries can also inhibit access.

Some governments do not provide reimbursement for essential cancer drugs, leaving patients to pay for them themselves.

Many countries lack the facilities and adequately trained health professionals to administer complex cancer drug regimens safely and effectively.

National opiate policies are often too restrictive: 80% of cancer patients who suffer severe pain have no access to morphine and other pain-relieving drugs.

Drug development is mainly driven by commercial considerations. The pharmaceutical industry spends $6.5-8 billion each year on cancer research; government and non-profit investment is much lower. Few if any drugs are available to treat rarer cancers.

Targeted therapies are revolutionizing the way cancer is managed, but their price is high and getting higher. As more targeted therapies are used as long-term maintenance therapy, the overall cost of cancer care will increase significantly and for many countries may become unaffordable.

Some pharmaceutical companies have established drug donation programmes in low-income countries, but these programmes are not a long-term solution to cancer drug access.

UICC calls on the international community to

* develop a comprehensive global strategy to facilitate cancer drugs access worldwide

* find a way to marry the need of ensuring equity in access to cancer drugs with that of protecting intellectual property rights

It calls on pharmaceutical companies to

* adopt transparent and consistent pricing policies for their products


* reduce the price of cancer drugs in low- and middle-income developing countries

* grant voluntary licences to governments in low-income countries to facilitate the production of generic versions of innovative cancer drugs

* increase investment in the research and development of drugs for cancers of high public health impact in low- and middle- income countries

* adopt an ethical approach to the marketing of innovative cancer drugs worldwide

* ensure that cancer drug donation programmes are developed with long-term drug access in mind

* develop new drug donation programme models that have greater long-term sustainability

And it calls on governments to

* acknowledge cancer as a health priority that requires adequate public funding within the context of a national cancer control plan

* provide rigorous and timely evaluation and licensing of all cancer drugs

* adopt a range of mechanisms to secure affordable prices for cancer drugs

* promote the rational use of cancer drugs by preparing national guidelines for the treatment of common cancers and ensuring that the cancer drugs that are included in national guidelines are listed in the national formulary of essential medicines

* ensure that health professionals have adequate training in the proper use of cancer drugs and the infrastructure necessary to ensure the safe and proper administration of these drugs

* reduce the amount of money patients have to pay themselves for cancer drugs

* introduce less restrictive national opiate policies to ensure that patients in severe pain can have easier access to opiates

* work with other stakeholder groups to tackle the increasing availability of counterfeit cancer medicines that cause significant harm to patients

* provide resources to support the research and development of new drugs needed to treat cancers with high public health impact in low- and middle-income countries

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