Despite Lower Prices, Cancer Drugs Less Affordable in Lower-Income Countries

Retail prices for 23 cancer drugs may be highest in the United States, but are less affordable in low-income countries despite lower retail prices.

Researchers who presented their work at the 2016 American Society of Clinical Oncology (ASCO) annual meeting found large differences in median retail prices for cancer drugs in different countries.

The retail prices of specifically 23 cancer drugs varied largely among the selected 7 countries that were studied. The highest retail prices were identified in the United States and the lowest were in India and South Africa.

“There are significant differences in drug prices across different countries, but even more important is that increasing prices are putting a significant burden on patients. More needs to be done to make treatments affordable and accessible for all patients,” Patricia Ganz, MD, spokesperson for ASCO, said in a statement.

The Scope of the Study

While earlier research has been sporadic and based on reports on single drugs in only a few countries or regions, the new study presented at ASCO went above and beyond. The researchers calculated monthly drug doses for 15 generic and 8 patented cancer drugs used to treat a wide range of cancer types and stages. The retail or list prices for the drugs in Australia, China, India, South Africa, United Kingdom, Israel, and the United States were obtained predominantly from government websites. The prices were then compared.

The researchers also took into consideration the gross domestic product (GDP) data for each country as it is a universal measure of national wealth based on the cost of living. The GDP and purchasing power parity data for each country was obtained from the International Monetary Fund.

Global Differences in Cancer Drug Prices

The median monthly retail price for patented drugs was $1515 (lowest) in India and $8694 (highest) in the US. In comparison, the median monthly retail price for generic drugs was $120 (lowest) in South Africa and $159 in India and $654 (highest) in the US.

However, affordability was a whole different issue. According to the study, cancer drugs were the most affordable in Australia, with monthly drug prices accounting for 3% of GDP for generics and 71% of GDP for patented drugs. The countries with the lowest ability to afford these drugs were China and India.

In China the monthly price of generics was 48% of GDP and 288% for patented drugs. In India, the cost of generics was 33% of GDP and the cost of patented drugs 313% of GDP. In the US, the cost of generics was 14% of GDP and the cost of patented cancer drugs was 192% of GDP.

Low Cost, but Still Can’t Afford

The study revealed enormous differences in median retail prices for cancer drugs in different countries. The highest retail prices were identified in the US and the lowest were in India and South Africa. However, when expressed as a percentage of purchasing power, cancer drugs were less affordable in low-income countries, despite the lower retail prices.

“This study provides a glimpse into prices and affordability of cancer drugs around the world and sets the stage for further research,” said lead study author Daniel A. Goldstein, MD, a senior physician in medical oncology at Rabin Medical Center in Petach Tkvah, Israel. “However, the implications of our findings are limited because we were not able to take discounts and rebates into account, which would better predict drug affordability.”