Access to and Affordability of World Health Organization Essential Medicines for Cancer in Sub-Saharan Africa: Examples from Kenya, Rwanda, and Uganda.
Access to and Affordability of World Health Organization Essential Medicines for Cancer in Sub-Saharan Africa: Examples from Kenya, Rwanda, and Uganda.
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DOI：
10.1093/oncolo/oyac143
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发表时间：
2022-11-03
期刊：
影响因子：
--
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文献类型：
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撒哈拉以南非洲的癌症死亡率很高，部分原因是治疗机会不足。我们利用肯尼亚、乌干达和卢旺达的例子，探讨了十大癌症治疗方案的可获得性和可负担性。人口、医疗融资、最低工资、癌症发病率和死亡率数据来自世界卫生组织、世界银行、公共来源和GLOBOCAN。国家基本药物清单（NEML）与2019年WHO EML的一致性被评估为比例。癌症治疗方案定价是使用公共和专有来源以及之前研究的方法计算的。通过全民医疗保险（UHC）的负担能力被评估为1年费用<3×人均国民总收入;对于患者自付（OOP），30天疗程费用<1天最低工资工作。共有93.4%的世卫组织EML癌症药物被列入2019年肯尼亚NEML，乌干达（2016年）和卢旺达（2015年）的NEML分别为70.5%和41.1%。通过全民健康覆盖，政府可以获得并负担得起非霍奇金淋巴瘤、宫颈癌、乳腺癌、前列腺癌、结肠直肠癌、卵巢癌和特定白血病的非专利化疗。通过政府的UHC采购，较新的靶向药物负担不起，而一些基于卡培他滨的治疗方案在乌干达和卢旺达负担不起。所有疗法都不是负担得起的OOP。并非所有癌症治疗方案都是OOP负担得起的，有些方案没有得到政府的资助。新的靶向药物不是所有三个政府都能负担得起的。癌症药物的UHC和提高SSA中LMIC政府的靶向治疗负担能力是改善治疗可及性和健康结果的关键。这项研究评估了基于2019年世界卫生组织基本药物清单（EML）适应症的治疗方案的可获得性和可负担性，用于肯尼亚，乌干达和卢旺达10种最常见的癌症。研究结果表明，所有癌症治疗方案对于自付患者来说都是负担不起的，并且新型基本靶向药物并不总是在国家EML上可用，并且通过全民医疗保险购买，所有3个国家的政府都负担不起。
Cancer mortality is high in sub-Saharan Africa (SSA), partly due to inadequate treatment access. We explored access to and affordability of cancer treatment regimens for the top 10 cancers utilizing examples from Kenya, Uganda, and Rwanda. Population, healthcare financing, minimum wage, and cancer incidence and mortality data were obtained from the WHO, World Bank, public sources, and GLOBOCAN. National Essential Medicines List (NEML) alignment with 2019 WHO EML was assessed as a proportion. Cancer regimen pricing was calculated using public and proprietary sources and methods from prior studies. Affordability through universal healthcare coverage (UHC) was assessed as 1-year cost <3× gross national income per capita; and to patients out-of-pocket (OOP), as 30-day treatment course cost <1 day of minimum wage work. A total of 93.4% of the WHO EML cancer medicines were listed on the 2019 Kenya NEML, and 70.5% and 41.1% on Uganda (2016) and Rwanda (2015) NEMLs, respectively. Generic chemotherapies were available and affordable to governments through UHC to treat non-Hodgkin’s lymphoma, cervical, breast, prostate, colorectal, ovarian cancers, and select leukemias. Newer targeted agents were not affordable through government UHC purchasing, while some capecitabine-based regimens were not affordable in Uganda and Rwanda. All therapies were not affordable OOP. All cancer treatment regimens were not affordable OOP and some were not covered by governments. Newer targeted drugs were not affordable to all 3 governments. UHC of cancer drugs and improving targeted therapy affordability to LMIC governments in SSA are key to improving treatment access and health outcomes. This study evaluated the access to, and affordability of treatment regimens based on 2019 WHO Essential Medicines List (EML) indications for the 10 most common cancers in Kenya, Uganda, and Rwanda. The findings demonstrate that all cancer treatment regimens were unaffordable to patients paying out-of-pocket and that novel essential targeted agents were not always available on country EMLs and were unaffordable to governments in all 3 countries through universal healthcare coverage purchasing.
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跨护理水平的药物可用性：加纳，肯尼亚和乌干达的设施调查的证据。
影响因子：
3.7
作者：
Masters SH;Burstein R;DeCenso B;Moore K;Haakenstad A;Ikilezi G;Achan J;Osei I;Garshong B;Kisia C;Njuguna P;Babigumira J;Kumar S;Hanlon M;Gakidou E
通讯作者：
Gakidou E
影响因子：
51.1
作者：
Duggan, Catherine;Trapani, Dario;Anderson, Benjamin O.
通讯作者：
Anderson, Benjamin O.
影响因子：
8.1
作者：
Faruqui, Neha;Martiniuk, Alexandra;Joshi, Rohina
通讯作者：
Joshi, Rohina
影响因子：
--
作者：
Garcia-Gonzalez, Pat;Boultbee, Paula;Epstein, David
通讯作者：
Epstein, David
DOI：
10.1093/annonc/mdx521
发表时间：
2017-11-01
期刊：
Annals of oncology : official journal of the European Society for Medical Oncology
影响因子：
--
作者：
Cherny NI;Sullivan R;Torode J;Saar M;Eniu A
通讯作者：
Eniu A