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):90-98. doi: 10.4103/2224-3151.239420.
In 2015, the need for equitable access to cancer treatments in low- and middle income countries was underscored by the addition of 16 essential cancer medicines to the 19th World Health Organization (WHO) model list of essential medicines (WHO EML). This study assessed the degree to which this expanded WHO EML from 2015 has influenced inclusion of cancer medicines in the most recent national essential medicines lists of the countries of the WHO South-East Asia Region.
The inclusion of a selected list of 38 essential cancer medicines in the 2015 WHO EML was assessed in the most recent national lists of essential medicines from the 11 countries of the WHO South-East Asia Region. Additionally, the availability of six essential cancer medicines common to the national lists of essential medicines from six countries of the WHO South-East Asia Region was explored.
Of the 38 selected essential cancer medicines included in the 19th WHO EML, a mean of 18.0 (range 2-33) were included in the national lists of countries of the WHO South-East Asia Region. Of the 25 essential cancer medicines included in the WHO EML prior to the 19th revision, a mean of 14.6 (range 2-21) were included in national lists; notably fewer of the 13 cancer medicines added in the 2015 revision were included: mean 3.4 (range 0-12).
Compared with the WHO EML, there is a lag in the inclusion of essential cancer medicines in national lists of essential medicines in the WHO South-East Asia Region. Alignment of essential cancer medicines in national lists of essential medicines among the 11 countries in the region varies significantly. These differences may hinder regional strategies to improve access to essential cancer medicines, such as pooled procurement of selected high-cost medicines. The link between the availability and affordability of essential cancer medicines warrants further investigation, in the context of access to medicines for universal health coverage.
2015年，16种基本癌症药物被列入第19版世界卫生组织（WHO）基本药物示范清单（WHO EML），这凸显了低收入和中等收入国家公平获得癌症治疗的必要性。本研究评估了2015年这份扩充后的WHO EML对WHO东南亚区域各国最新国家基本药物清单中癌症药物纳入情况的影响程度。
对WHO东南亚区域11个国家最新的国家基本药物清单中2015年WHO EML所选的38种基本癌症药物的纳入情况进行了评估。此外，还探讨了WHO东南亚区域6个国家国家基本药物清单中共有的6种基本癌症药物的可及性。
在第19版WHO EML中所选的38种基本癌症药物中，WHO东南亚区域各国的国家清单平均纳入了18.0种（范围为2 - 33种）。在第19版修订之前的WHO EML中包含的25种基本癌症药物，各国国家清单平均纳入了14.6种（范围为2 - 21种）；值得注意的是，2015年修订版中新增的13种癌症药物纳入的较少：平均为3.4种（范围为0 - 12种）。
与WHO EML相比，WHO东南亚区域各国国家基本药物清单中基本癌症药物的纳入存在滞后。该区域11个国家国家基本药物清单中基本癌症药物的一致性差异显著。这些差异可能会阻碍改善基本癌症药物可及性的区域战略，如选定的高成本药物的集中采购。在全民健康覆盖的药品可及性背景下，基本癌症药物的可及性与可负担性之间的联系值得进一步研究。
