Chivukula Meenakshi V, Tisocki Klara
Independent consultant, New Delhi, India.
World Health Organization Regional Office for South-East Asia, New Delhi, India.
WHO South East Asia J Public Health. 2018 Sep;7(2):62-66. doi: 10.4103/2224-3151.239415.
The high cancer burden in the World Health Organization (WHO) South-East Asia Region represents not only a significant cause of death, disability and suffering but also a major threat to development. In 2015, the need for equitable access to cancer treatments was underscored by the addition of 16 cancer drugs to the 19th WHO model list of essential medicines, including three high-cost medicines. This paper explores strategies to improve access, including - but not limited to - managing costs through regional cooperation; coordinated procurement mechanisms; price controls; differential pricing; and licensing agreements. The composition of the region, with small and large pharmaceutical markets with a range of manufacturing capacities and supply-chain issues, offers a unique frame of comparison and consideration for access issues. Different approaches are needed that are tailored to specific country situations. However, in the absence of global collaborative funding mechanisms, the region can advocate now, with one voice, for regional action to improve the affordability and availability of essential cancer medicines and align national cancer-control strategies to leverage regional strengths. Delays will lead to more premature cancer deaths and more households in the WHO South-East Asia Region being impoverished through out-of-pocket payments for cancer medicines.
世界卫生组织(WHO)东南亚区域的高癌症负担不仅是死亡、残疾和痛苦的重要原因,也是对发展的重大威胁。2015年,第19版WHO基本药物示范清单新增了16种癌症药物,其中包括三种高成本药物,这凸显了公平获得癌症治疗的必要性。本文探讨了改善可及性的策略,包括但不限于通过区域合作控制成本;协调采购机制;价格管制;差别定价;以及许可协议。该区域由大小不一的制药市场组成,存在一系列生产能力和供应链问题,为获取问题提供了独特的比较和考量框架。需要针对具体国家情况采取不同方法。然而,在缺乏全球合作资助机制的情况下,该区域现在可以统一发声,倡导采取区域行动,以提高基本癌症药物的可承受性和可及性,并调整国家癌症控制战略以利用区域优势。拖延将导致更多癌症患者过早死亡,以及东南亚区域更多家庭因自费购买癌症药物而陷入贫困。