E-DRUG: World Cancer Day: Cancer medicines & monopolies-perpetuating inequalities
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Link to the report by Ellen t'Hoen
_http://policy-practice.oxfam.org.uk/publications/access-to-cancer-treatment-a-study-of-medicine-pricing-issues-with-recommendati-344070_
Cancer, a global cause of death and suffering is on the rise. WHO
estimates that cancers accounted for 8.2 million deaths in 2012 which is
projected to increase to 11.5 million deaths by 2030. The majority of
cancer mortality and morbidity (70% of deaths and 60% of new cases in
2012) is in developing countries.
<http://www.who.int/mediacentre/factsheets/fs297/en/>\.
Weak access to prevention and to early diagnosis exacerbates illness in these
countries. Moreover, the high cost of treatment pushes people deeper
into poverty, resulting in a rising inequality.
The report on the pricing of medicines for cancer treatment by Ellent 'Hoen discusses
the unsustainability of the high prices of newer medicines. The report
also provides evidence of a problem that is looming large not only in
low- and middle-income countries (LMICs) but also in wealthy countries.
The report points out that while numbers of cancer deaths are reducing
in wealthy countries because of access to early diagnosis and treatment,
the incidence and prevalence is increasing in developing countries. In
India it is projected that the number of patients with cancer will reach
1.1 million by 2020. When cancer medicines are priced out of the reach
of most people living in developing countries, it compounds the
challenges of accessing treatment, exacerbating illness and contributing
to preventable suffering.
Even in rich countries the prices of newer cancer medicines are being
questioned against a backdrop of escalating health care costs. For
example, the recent decision to_delist 16 medicines from the UK's
Cancer Drug Fund_
<http://www.sciencemediacentre.org/expert-reaction-to-review-of-drugs-paid-for-by-the-cancer-drugs-fund/>
has elicited furious debate about the high price tag of treatments that
deliver limited clinical benefits and equity in providing access to all
patients under the NHS.
Access to anticancer medicines is aggravated the world over by
intellectual property rights held by pharmaceutical companies and by
companies' pricing strategies. Multinational pharmaceutical companies
holding the intellectual rights to new medicines justify high and often
exorbitant prices as a necessary means to recover research and
development (R&D) costs. However, this explanation is not possible to
verify since transparency about costs is lacking. In addition, public
funding contributes significantly to the development of new cancer
medicines.
The report contrasts the best estimates of Novartis' R&D
expenditure on imatinib (Glivec), $38-96 million, with the sales of the
drug in 2012 which came to $4.7 billion. Pricing to maximise profits has
proven to be very lucrative for pharmaceutical companies. The
industry's global oncology sales were worth $61.45 billion in 2012 and
are expected to increase to $81.3 billion by 2018.
There is now a global consensus that the current R&D model that
maintains monopolies and leads to high prices of medicines is broken.
New ways of financing biomedical innovation that de-link the cost of R&D
from the price of the product are being debated and piloted at the WHO.
Yet there is intense pressure on governments that are taking measures to
increase affordability and access to medicines from the pharmaceutical
industry and the governments protecting its interests. The current
pressures on India are a prime example.
The US government, on behalf of the commercial interests of its
pharmaceutical companies, is engaged in an intense effort to undermine
India's use of public health safeguards enshrined in India's
intellectual property regime. The industry seeks to force the
introduction of TRIPS-plus provisions (such as data exclusivity and
patent linkage) that will prolong monopolies on medicines and delay
generic entry into the market. India has now been stopped from advancing
a compulsory license for an anti-leukaemia medicine, dasatinib.
Experiences from the global fight for HIV treatment over the last decade
have taught us that generic competition is the most robust and effective
way of bringing down the price of medicines. If the US government is
successful in imposing its demands on India, the generic supply of life
saving medicines and the health of people living in India and other
developing countries will be seriously threatened.
The Access to Cancer Treatment report presents evidence of the scale of
the problem of access to cancer medicines and recommends how it may be
tackled. What is clear is that we are at a tipping point where high
prices for cancer medicines and the resulting lack of access to
treatment are neither justified nor acceptable. The stage is set for the
governments to act in favour of patients and to find workable solutions
to what has become one the greatest challenges to equity and access to
medicines in our time. Will we act?
Philippa Saunders
UK
iPhone: 07796075366
e-mail: philippa.m.saunders@gmail.com