Varmaghani Mehdi, Elyasi Sepideh, Mojahedian Mohammad M, Ghavami Vahid, Borhani Behnam, Javan-Noughabi Javad, Sarafraz Shirin
Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Support Care Cancer. 2022 Dec 27;31(1):89. doi: 10.1007/s00520-022-07546-w.
Cancer is the second leading cause of death in the world after cardiovascular disease. The present study aimed to investigate the affordability and physical access to chemotherapy drugs among patients with one of the three common cancers of the breast, stomach, and colon in the city of Mashhad, Iran, in 2021.
This was a descriptive cross-sectional study. Twenty drug stores including two public and 18 privates in Mashhad were evaluated. Data was collected by consistent stay in the drug stores or pharmacies. For each oncology medicine, selling price, lowest general price, and availability were investigated. Three approaches have been experimented to calculate the affordability of anticancer medicines in this study.
Out of 28 studied medicines from public and private drug stores, 15 (53.5%) received very low, 8 (28.5%) relatively high, and 2 (7%) high access scores. The generic docetaxel brand's ultra-drug and trastuzumab (AryoTrust) were the most available drugs, but the doxorubicin (Ebewe), oxaliplatin (Mylan), and trastuzumab (Herceptin) were not available to the individuals with cancer. Also, the first approach (based on income decile) indicated that insured patients from all income deciles were able to pay the costs of the lowest price drugs of the DCF drug regimen, and if the patients were insured and belonged to the ninth income decile, they had the financial ability to buy drugs at the lowest price of the FLO drug regimen.
Unaffordability of cancer medicines can lead to treatment abandonment and increase inequality in access to healthcare services. Therefore, this requires immediate attention of policy makers to be planned in order to ensure to reducing the costs of medicines for patients and increasing patient access to anticancer medicines.
癌症是全球仅次于心血管疾病的第二大死因。本研究旨在调查2021年伊朗马什哈德市乳腺癌、胃癌和结肠癌这三种常见癌症患者对化疗药物的可负担性及实际可获取情况。
这是一项描述性横断面研究。对马什哈德的20家药店进行了评估，其中包括2家公立药店和18家私立药店。通过在药店持续停留收集数据。对每种肿瘤药物的售价、最低通用价格和可获得性进行了调查。本研究尝试了三种方法来计算抗癌药物的可负担性。
在公立和私立药店研究的28种药物中，15种（53.5%）的可获取分数极低，8种（28.5%）相对较高，2种（7%）较高。多西他赛仿制药品牌的超药品和曲妥珠单抗（AryoTrust）是最容易获得的药物，但阿霉素（Ebewe）、奥沙利铂（迈兰）和曲妥珠单抗（赫赛汀）癌症患者无法获得。此外，第一种方法（基于收入十分位数）表明，所有收入十分位数的参保患者都有能力支付DCF药物方案中最低价格药物的费用，并且如果患者参保且属于第九收入十分位数，他们有经济能力购买FLO药物方案最低价格的药物。
抗癌药物负担不起可能导致放弃治疗，并加剧医疗服务获取方面的不平等。因此，这需要政策制定者立即予以关注并进行规划，以确保降低患者的药品成本，并增加患者获得抗癌药物的机会。
