ESMO International Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in countries outside of Europe.
ESMO International Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in countries outside of Europe.
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DOI：
10.1093/annonc/mdx521
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发表时间：
2017-11-01
期刊：
影响因子：
--
通讯作者：
Eniu A
中科院分区：
文献类型：
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作者：
Cherny NI;Sullivan R;Torode J;Saar M;Eniu A
安全、有效、高质量、负担得起的抗癌疗法的可获得性和可负担性是有效的国家癌症控制计划的核心要求。基于先前验证的方法的在线调查。这项研究的目的是评估(I)全球获得许可的抗肿瘤药物在国家处方中的可获得性，(Ii)患者自付药物的费用，(Iii)拥有有效处方的患者的实际药物可获得性，(Iv)与可能对抗肿瘤药物可获得性产生不利影响的因素有关的信息，以及(V)国家经济发展水平对这些参数的影响。共有来自97个国家的304名实地记者应邀参加。初步数据已张贴在ESMO网站上，以供公开同行审查，修正案已纳入最后报告。来自63个国家的135名记者提交了调查，来自19个国家的54名记者提交了额外的同行审查数据。许多抗癌药物在处方可获得性、自付成本和实际可获得性方面存在很大差异。最重要的问题在低收入、中等收入和低收入国家。即使在世卫组织基本药物标准清单(EML)上的药物中，差异也很大，这与高自付成本有关(在低收入和中等收入国家，32.0%的EML药物只能全价获得，5.2%根本无法获得，而对于低收入国家，相应的数字更糟，分别为57.7%和8.3%)。大多数获得许可的抗癌药物在处方可获得性、自付费用和实际可获得性方面存在广泛的全球差异。与高收入国家相比，低收入和中低收入国家在世卫组织EML上严重缺乏癌症药物的可获得性和高自付费用，可获得的新的、更昂贵的靶向药物要少得多。
The availability and affordability of safe, effective, high-quality, affordable anticancer therapies are a core requirement for effective national cancer control plans. Online survey based on a previously validated approach. The aims of the study were to evaluate (i) the availability on national formulary of licensed antineoplastic medicines across the globe, (ii) patient out-of-pocket costs for the medications, (iii) the actual availability of the medication for a patient with a valid prescription, (iv) information relating to possible factors adversely impacting the availability of antineoplastic agents and (v) the impact of the country’s level of economic development on these parameters. A total of 304 field reporters from 97 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer review and amendments have been incorporated into the final report. Surveys were submitted by 135 reporters from 63 countries and additional peer-review data were submitted by 54 reporters from 19 countries. There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most substantial issues are in lower-middle- and low-income countries. Even among medications on the WHO Model List of Essential Medicines (EML) the discrepancies are profound and these relate to high out-of-pocket costs (in low-middle-income countries 32.0% of EML medicines are available only at full cost and 5.2% are not available at all, and for low-income countries, the corresponding figures are even worse at 57.7% and 8.3%, respectively). There is wide global variation in formulary availability, out-of-pocket expenditures and actual availability for most licensed anticancer medicines. Low- and low-middle-income countries have significant lack of availability and high out-of-pocket expenditures for cancer medicines on the WHO EML, with much less availability of new, more expensive targeted agents compared with high-income countries.