Access to innovative cancer medicines in a middle-income country - the case of Mexico

Abstract

BackgroundCancer has become the third cause of death in Mexico. Treatment for cancer is often complex and lengthy. New and better medicines enter the market at high prices, which may limit access. Like most Latin American countries, Mexico has an essential cancer medicines list that includes innovative medicines. Their accessibility and use in the public sector remains unknown. Therefore, we describe the use, as a proxy of access, of innovative and essential cancer medicines in the public sector in Mexico, by insurance institution, and by five regions between 2010 to 2016.MethodsWe used drug utilization research methods to assess the use of eight patented cancer medicines. Through the national transparency platform, we obtained data on the quantities of these medicines used in all public health facilities and social health insurance institutions and recalculated those figures into defined daily dose (DDD) per 1000 population per year.ResultsOverall, the use of all medicines increased over the years, especially for trastuzumab, rituximab and imatinib. The use of innovative medicines was higher per population covered in social health insurance institutions than in governmental facilities. Throughout the study period, the Central region (including Mexico City) has used more medicines per population than the other regions.ConclusionsThe use and access of some essential innovative cancer medicines has increased over the years, but remains unequal across insurance schemes and regions. Particularly, the Ministry of Health Insurance scheme and Northern and Western regions in the country would benefit from additional efforts to increase access to essential cancer medicines.

Availability, Affordability, Access, and Pricing of Anti-cancer Medicines in Low- and Middle-Income Countries: A Systematic Review of Literature

“…Overall, 13 studies were included in the review with some having multiple outcomes: five studies (16)(17)(18)(19)(20) were on the pricing of anticancer medicines, four studies (4,18,21,22) addressed affordability of anti-cancer medicines, and five studies reported (8,18,20,22,23) on the availability of anticancer medicines and overall four studies (8,(24)(25)(26) was on access to anti-cancer medicines.…”

“…Four studies (8,(24)(25)(26) demonstrated that barriers to access and use of innovative cancer medicines are linked to the limited coverage of public insurance schemes (26), non-inclusion in the EML ( 24), non-availability of the medicine at the facilities, and updated clinical guidelines (24)(25)(26). The innovation field for anticancer medicines is growing (36).…”

“…A study showed that over 80% of the population experience barriers to accessing innovative medicines (26), that could provide them with better outcomes of their treatment against cancer. The access barriers include geographic location, inequality across insurance schemes, health care coverage (by medicine and cancer medication types), regional variations, and institutions (with the private providing more per insured population than the MoH).…”

“…Studies on access showed large variability within income groups of what was identified as essential in NEMLs and National Reimbursable Medicine List (NRMLs) (24,26). A study (24) explored access in 135 LMICs, to the 18 essential and 8 ancillary antineoplastic medicines proposed by the International Society of Pediatric Oncology (SIOP) to be essential in the supportive care of children with cancer.…”

“…In studies (24,26), there are certainly highlighted inequalities in access to cancer care. Barriers to access and use of innovative The prices of a basket of 8 cancer drugs those with known prices in all 7 countries, was converted to US$ using both foreign exchange rates and purchasing power parity.…”