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