Medical Oncology Department, VI University Hospital, Marrakech, Mohammed, 40000, Morocco.
Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, 40000, Morocco.
Int J Equity Health. 2024 Oct 21;23(1):217. doi: 10.1186/s12939-024-02262-9.
The cost of cancer drugs presents a significant challenge to accessibility of treatment worldwide. Projections indicate that by 2040, two-thirds of cancer cases will occur in low- and middle- income countries. Paradoxically, despite this impending burden, LMICs command less than 5% share of global resources for treating cancer. Morocco, like many LMICs, faces significant obstacles in providing innovative cancer treatments to its population.
Firstly, we aimed to conduct an original research investigating the availability and affordability of innovative cancer drugs in Morocco. Secondly, we sought to review the broader market dynamics, pricing, and reimbursement policies in the country.
For the first objective, we identified a preliminary list of medicines approved for oncological indications in the Moroccan market based on resources from ANAM (National Agency for Health Insurance), pharmacy regulators, and online resources that compile information on approved medicines. For the second objective, we exhaustively reviewed the regulatory documents, legal texts and grey literature reports. All the informations were examined by pharma delegates and local experts.
As of January 2024, Morocco has 39 innovative anticancer medicines with market authorization. 30% of these drugs were approved after 2020. The majority of approved drugs were for breast, lung, colorectal, and prostate cancer. The period between FDA approval and entry into the Moroccan market ranges from 2 to 7 years, with a median of 3 years for breast cancer drugs and 7 years for more expensive drugs like Olaparib and Osimertinib. 22 out of the 39 drugs are not reimbursed, with an average reimbursement time of 4 years. Compared to prices in France, the most notable pricing disparities concern immunotherapy agents, priced 600 to 900 euros lower in France, while drugs like Pazopanib and Erlotinib cost 50% less in Morocco.
Our study reveals significant disparities in the availability and affordability of innovative cancer drugs in Morocco. Regulatory hurdles, importation challenges, and pricing strategies contribute to this inequitable landscape. Addressing systemic barriers, fostering collaborations between stakeholders, and adopting a value-based pricing approach are imperative steps toward ensuring equitable access to high-quality interventions for patients, regardless of their geographical location.
癌症药物的成本给全球的治疗可及性带来了重大挑战。据预测，到 2040 年，三分之二的癌症病例将发生在中低收入国家。矛盾的是，尽管面临着如此沉重的负担，中低收入国家在全球癌症治疗资源中所占份额还不到 5%。摩洛哥与许多中低收入国家一样，在为其民众提供创新癌症治疗方面面临着重大障碍。
首先，我们旨在开展一项原始研究，调查摩洛哥创新癌症药物的可及性和可负担性。其次，我们旨在审查该国更广泛的市场动态、定价和报销政策。
为了实现第一个目标，我们根据 ANAM（国家医疗保险机构）、药剂监管机构和在线资源中有关批准药品的信息，确定了一份初步的摩洛哥市场批准用于肿瘤适应症的药品清单。为了实现第二个目标，我们全面审查了监管文件、法律文本和灰色文献报告。所有信息都由药剂代表和当地专家进行了审查。
截至 2024 年 1 月，摩洛哥有 39 种创新抗癌药物获得市场授权。其中 30%的药物是在 2020 年后批准的。大多数批准的药物用于乳腺癌、肺癌、结直肠癌和前列腺癌。从 FDA 批准到进入摩洛哥市场的时间间隔为 2 至 7 年，乳腺癌药物的中位数为 3 年，而奥希替尼和奥拉帕利等更昂贵药物的中位数为 7 年。39 种药物中有 22 种未报销，平均报销时间为 4 年。与法国的价格相比，最显著的定价差异涉及免疫治疗药物，法国的价格低 600 至 900 欧元，而帕唑帕尼和厄洛替尼等药物在摩洛哥的价格低 50%。
我们的研究揭示了摩洛哥创新癌症药物的可及性和可负担性方面存在显著差异。监管障碍、进口挑战和定价策略导致了这种不公平的局面。解决系统性障碍、促进利益相关者之间的合作以及采用基于价值的定价方法，对于确保无论患者地理位置如何，都能平等获得高质量的干预措施，至关重要。
