Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

Abstract

Background: More alternatives have become available for the diagnosis and treatment of cancer in low-and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

Evaluating essential medicines for treating childhood cancers: availability, price and affordability study in Ghana

“…However, the cost of chemotherapy treatment for ALL and retinoblastoma was not affordable. Our result is similar to other studies done in LMICs, which reported that cancer medicines are not affordable [ 26 , 27 , 42 ].…”

Comparison of Prices and Affordability of Cancer Medicines in 16 Countries in Europe and Latin America

“…The selection of medicines was based on a previous study (pricing survey) conducted in Mexico in 2017. In that study [48], medicines were selected based on their clinical relevance confirmed by their inclusion in the national formulary, their reimbursement by the public health insurance, and their inclusion in national treatment guidelines. Additionally, acknowledging the dynamics in medicine prices following patent expiry, the current study aimed to focus on on-patent medicines; thus, medicines that were included were under patent protection in Mexico in 2017 (time of the survey).…”

“…Prices for Mexico were collected in 2017 through a primary price data survey using the World Health Organization (WHO)/Health Action International (HAI) methodology [48,49]. The WHO/HAI methodology [50] is an internationally acknowledged tool for measuring medicine prices, availability and affordability.…”

What Factors Hindered the Access to Essential Anti-Cancer Medicine in Public Hospitals amongst the Local Population in Hubei Province, China?

“…They collected information regarding the cost and availability using a standardized data collection form. At the end of each day, 2 students would enter the data into a designed MS Excel Workbook provided as a part of the WHO/ HAI methodology [14,15] . The items included in the standardized form were as follows: basic information of the facility (hospital name, hospital level, survey date), information of the medicine (medicine in stock in the hospital on the day of data collection, yes or no), dosage, strength, medicine type (OB/LPG), and the retail price at the time of survey ( Table 1) .…”

“…Moreover, the price of many anticancer drugs is too expensive, which causes heavy economic burden for cancer patients. Thus, with the aim to precisely assess the affordability, we used the approach proposed by Khatib and Sarwar [18,19] : if the total expenditure of medicine in 30 days accounted for 20% or less of the minimum family monthly income, it was regarded as affordable [15] . The calculation formula was :…”