Saqib Anum, Iftikhar Sadia, Sarwar Muhammad Rehan
Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Punjab, Pakistan.
Department of Pharmacy Practice, Akhtar Saeed College of Pharmaceutical Sciences, Lahore, Pakistan.
BMJ Open. 2018 Jun 14;8(6):e019015. doi: 10.1136/bmjopen-2017-019015.
Prime focus of this study was to evaluate the availability and affordability of originator brands (OBs) and lowest price generics (LPGs) of prescribed biologic and non-biologic anticancer medicines.
DESIGN, SETTINGS AND PARTICIPANTS: A descriptive, cross-sectional survey was conducted in 22 cancer-care hospitals (18 public hospitals and 4 private hospitals) and 44 private pharmacies in Punjab, Pakistan. Sampling population consisted of 4483 patients with cancer aged ≥18 years. The availability was determined by classifying anticancer medicines in four categories: absent/unavailability (medicines not present in any surveyed facility), low availability (medicines present in <50% of surveyed facilities), fairly high availability (medicines present in 50%-74% of surveyed facilities) and high availability (medicines present in >75% of surveyed facilities). Medicines were affordable if overall cost of all the prescribed anticancer medicines were 20% of the household capacity to pay. Data were analysed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, V.21.0).
A total of 5060 patients with cancer were approached out of which 4483 patients were included in the survey. Overall, 10 103 anticancer drugs were prescribed. Among them, 96.3% were non-biologics and 3.7% were biologics. Oncologists were reluctant to prescribe biologics due to high prices. 58.1% of non-biologics were affordable; whereas, the affordability of biologics was 3.3%. A total of 43.9% of both biologic and non-biologic OBs were available; whereas, their affordability was 44.2%. On the other hand, the availability of LPGs was 21.3%, and their affordability was 66.1%. For low-income patients, the affordability of non-biologics was 31.6% and the affordability of biologics was 1.1%.
Most of the patients with cancer were prescribed non-biologics due to their low price and better affordability. In contrast to OBs, LPGs of both biologics and non-biologics had less availability but more affordability.
本研究的主要重点是评估处方生物和非生物抗癌药物的原研品牌药（OBs）和最低价仿制药（LPGs）的可及性和可负担性。
设计、背景与参与者：在巴基斯坦旁遮普省的22家癌症护理医院（18家公立医院和4家私立医院）和44家私人药房进行了一项描述性横断面调查。抽样人群包括4483名年龄≥18岁的癌症患者。可及性通过将抗癌药物分为四类来确定：无/不可用（任何被调查机构均无该药物）、低可及性（<50%的被调查机构有该药物）、相当高可及性（50%-74%的被调查机构有该药物）和高可及性（>75%的被调查机构有该药物）。如果所有处方抗癌药物的总成本占家庭支付能力的20%，则该药物为可负担的。数据使用社会科学统计软件包（IBM SPSS Statistics for Windows，版本21.0）进行分析。
共接触了5060名癌症患者，其中4483名患者纳入调查。总体而言，共开出了10103种抗癌药物。其中，96.3%为非生物药，3.7%为生物药。由于价格高昂，肿瘤学家不愿开生物药。58.1%的非生物药是可负担的；而生物药的可负担性为3.3%。生物和非生物原研品牌药的总体可及性为43.9%；而其可负担性为44.2%。另一方面，最低价仿制药的可及性为21.3%，其可负担性为66.1%。对于低收入患者，非生物药的可负担性为31.6%，生物药的可负担性为1.1%。
大多数癌症患者因价格低廉和可负担性较好而被开非生物药。与原研品牌药相比，生物和非生物最低价仿制药的可及性较低，但可负担性较高。
