[Ip-health] World Cancer Day: Prices of cancer medicines perpetuating inequality

Mohga Kamal-Yanni mkamalyanni at Oxfam.org.uk
Wed Feb 4 10:44:57 PST 2015

Link to the blog by Malini Aisola 

Link to the report by Ellen t'Hoen 

Cancer, a global cause of death and suffering is on the rise. WHO 
estimates that cancers accounted for 8.2 million deaths in 2012 which is 
projected to increase to 11.5 million deaths by 2030. The majority of 
cancer mortality and morbidity (70% of deaths and 60% of new cases in 
2012) is in developing countries. Weak access to prevention and to early 
diagnosis exacerbates illness in these countries. Moreover, the high cost 
of treatment pushes people deeper into poverty, resulting in a rising 
A report on the pricing of medicines for cancer treatment by Ellen‘t Hoen 
discusses the unsustainability of the high prices of newer medicines. The 
report also provides evidence of a problem that is looming large not only 
in low- and middle-income countries (LMICs) but also in wealthy countries. 

The report points out that while numbers of cancer deaths are reducing in 
wealthy countries because of access to early diagnosis and treatment, the 
incidence and prevalence is increasing in developing countries. In India 
it is projected that the number of patients with cancer will reach 1.1 
million by 2020. When cancer medicines are priced out of the reach of most 
people living in developing countries, it compounds the challenges of 
accessing treatment, exacerbating illness and contributing to preventable 
Even in rich countries the prices of newer cancer medicines are being 
questioned against a backdrop of escalating health care costs. For 
example, the recent decision to delist 16 medicines from the UK’s Cancer 
Drug Fund has elicited furious debate about the high price tag of 
treatments that deliver limited clinical benefits and equity in providing 
access to all patients under the NHS. 
Access to anticancer medicines is aggravated the world over by 
intellectual property rights held by pharmaceutical companies and by 
companies’ pricing strategies. Multinational pharmaceutical companies 
holding the intellectual rights to new medicines justify high and often 
exorbitant prices as a necessary means to recover research and development 
(R&D) costs. However, this explanation is not possible to verify since 
transparency about costs is lacking. In addition, public funding 
contributes significantly to the development of new cancer medicines. The 
report contrasts the best estimates of Novartis’ R&D expenditure on 
imatinib (Glivec), $38-96 million, with the sales of the drug in 2012 
which came to $4.7 billion. Pricing to maximise profits has proven to be 
very lucrative for pharmaceutical companies. The industry’s global 
oncology sales were worth $61.45 billion in 2012 and are expected to 
increase to $81.3 billion by 2018. 
There is now a global consensus that the current R&D model that maintains 
monopolies and leads to high prices of medicines is broken. New ways of 
financing biomedical innovation that de-link the cost of R&D from the 
price of the product are being debated and piloted at the WHO. 
Yet there is intense pressure on governments that are taking measures to 
increase affordability and access to medicines from the pharmaceutical 
industry and the governments protecting its interests. The current 
pressures on India are a prime example. 
The US government, on behalf of the commercial interests of its 
pharmaceutical companies, is engaged in an intense effort to undermine 
India’s use of public health safeguards enshrined in India’s intellectual 
property regime. The industry seeks to force the introduction of 
TRIPS-plus provisions (such as data exclusivity and patent linkage) that 
will prolong monopolies on medicines and delay generic entry into the 
market. India has now been stopped from advancing a compulsory license for 
an anti-leukaemia medicine, dasatinib. 
Experiences from the global fight for HIV treatment over the last decade 
have taught us that generic competition is the most robust and effective 
way of bringing down the price of medicines. If the US government is 
successful in imposing its demands on India, the generic supply of life 
saving medicines and the health of people living in India and other 
developing countries will be seriously threatened. 
The Access to Cancer Treatment report presents evidence of the scale of 
the problem of access to cancer medicines and recommends how it may be 
tackled. What is clear is that we are at a tipping point where high prices 
for cancer medicines and the resulting lack of access to treatment are 
neither justified nor acceptable. The stage is set for the governments to 
act in favour of patients and to find workable solutions to what has 
become one the greatest challenges to equity and access to medicines in 
our time. Will we act? 

Happy New Year عام سعيد علي العالم
Best wishes مع أطيب التحيات
Mohga (Dictating to the computer so please forgive silly mistakes) 
Mohga M Kamal-Yanni
Senior health & HIV policy advisor, Oxfam GB
John Smith Drive, Oxford, OX4 2JY, UK (GMT, CET-1, EDT+5, EST+6)
UK Mobile   + 44 (0)777 62 55 884
Follow me @MohgaKamalYanni 

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