Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania, USA.
BMJ Glob Health. 2024 Oct 8;9(9):e015700. doi: 10.1136/bmjgh-2024-015700.
Despite progress in the development of new cancer drugs, concerns about equity of access remain. This study aimed to examine the availability and timeliness of availability of new cancer drugs around the globe over the past three decades and their associations with country characteristics.
From a pharmaceutical intelligence database we identified new cancer drugs launched between 1990 and 2022. We calculated the number of new drugs launched in each country and the delay in launches. Using a multivariable linear regression and a Cox regression model with shared frailty, we examined the associations of the country's Gross National Income (GNI) per capita, cancer incidence, number of physicians per population, and Gini index with the number of new cancer drug launches and launch delay in a country, respectively.
A total of 568 cancer drugs were launched for the first time globally between 1990 and 2022. Among these, 35% had been launched in only one country by 2022, 22% in 2-5 countries, 15% in 6-10 countries, and 28% in more than 10 countries. The number of new cancer drugs launched in a country in this period ranged from 0 to 345. The average delays from the first global launch to the second, third, fourth, and fifth launch were 18.0 months, 24.3 months, 32.5 months, and 39.4 months, respectively. Our multivariate models showed that higher GNI per capita and cancer incidence in a country were associated with more launches and shorter delays.
This research reveals significant disparities in the availability and timeliness of availability of new cancer drugs across countries. These disparities are likely to have contributed to the poor cancer outcomes observed in many countries.
尽管新抗癌药物的研发取得了进展，但人们对获得药物的公平性仍存在担忧。本研究旨在考察过去三十年来全球新抗癌药物的供应情况及其可及性，并分析其与国家特征的关联。
我们从一个药物情报数据库中确定了 1990 年至 2022 年间推出的新抗癌药物。我们计算了每个国家推出的新药数量和推出时间的延迟。我们使用多变量线性回归和具有共享脆弱性的 Cox 回归模型，分别考察了国家人均国民总收入（GNI）、癌症发病率、每人口医生数量和基尼指数与国家新抗癌药物推出数量和推出延迟的关联。
1990 年至 2022 年期间，全球共推出了 568 种新抗癌药物。其中，到 2022 年，仅有一个国家推出了 35%的药物，2-5 个国家推出了 22%，6-10 个国家推出了 15%，10 个以上国家推出了 28%。在此期间，一个国家推出的新抗癌药物数量从 0 到 345 不等。从全球首次推出到第二次、第三次、第四次和第五次推出的平均延迟分别为 18.0 个月、24.3 个月、32.5 个月和 39.4 个月。我们的多变量模型表明，一个国家的人均 GNI 和癌症发病率越高，推出的药物数量越多，推出的延迟时间越短。
本研究揭示了各国新抗癌药物供应情况及其可及性存在显著差异。这些差异可能导致许多国家的癌症治疗结果不佳。
