TY - JOUR
T1 - Enhancing global access to cancer medicines
AU - Cortes, Javier
AU - Perez-García, Jose Manuel
AU - Llombart-Cussac, Antonio
AU - Curigliano, Giuseppe
AU - El Saghir, Nagi S.
AU - Cardoso, Fatima
AU - Barrios, Carlos H.
AU - Wagle, Shama
AU - Roman, Javier
AU - Harbeck, Nadia
AU - Eniu, Alexandru
AU - Kaufman, Peter A.
AU - Tabernero, Josep
AU - García-Estévez, Laura
AU - Schmid, Peter
AU - Arribas, Joaquín
N1 - Funding Information:
The authors would like to thank Sunil P. Verma, MD, for his contribution and review of this work.
Publisher Copyright:
© 2020 American Cancer Society
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Globally, cancer is the second leading cause of death, with numbers greatly exceeding those for human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, and malaria combined. Limited access to timely diagnosis, to affordable, effective treatment, and to high-quality care are just some of the factors that lead to disparities in cancer survival between countries and within countries. In this article, the authors consider various factors that prevent access to cancer medicines (particularly access to essential cancer medicines). Even if an essential cancer medicine is included on a national medicines list, cost might preclude its use, it might be prescribed or used inappropriately, weak infrastructure might prevent it being accessed by those who could benefit, or quality might not be guaranteed. Potential strategies to address the access problems are discussed, including universal health coverage for essential cancer medicines, fairer methods for pricing cancer medicines, reducing development costs, optimizing regulation, and improving reliability in the global supply chain. Optimizing schedules for cancer therapy could reduce not only costs, but also adverse events, and improve access. More and better biomarkers are required to target patients who are most likely to benefit from cancer medicines. The optimum use of cancer medicines depends on the effective delivery of several services allied to oncology (including laboratory, imaging, surgery, and radiotherapy). Investment is necessary in all aspects of cancer care, from these supportive services to technologies, and the training of health care workers and other staff.
AB - Globally, cancer is the second leading cause of death, with numbers greatly exceeding those for human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, and malaria combined. Limited access to timely diagnosis, to affordable, effective treatment, and to high-quality care are just some of the factors that lead to disparities in cancer survival between countries and within countries. In this article, the authors consider various factors that prevent access to cancer medicines (particularly access to essential cancer medicines). Even if an essential cancer medicine is included on a national medicines list, cost might preclude its use, it might be prescribed or used inappropriately, weak infrastructure might prevent it being accessed by those who could benefit, or quality might not be guaranteed. Potential strategies to address the access problems are discussed, including universal health coverage for essential cancer medicines, fairer methods for pricing cancer medicines, reducing development costs, optimizing regulation, and improving reliability in the global supply chain. Optimizing schedules for cancer therapy could reduce not only costs, but also adverse events, and improve access. More and better biomarkers are required to target patients who are most likely to benefit from cancer medicines. The optimum use of cancer medicines depends on the effective delivery of several services allied to oncology (including laboratory, imaging, surgery, and radiotherapy). Investment is necessary in all aspects of cancer care, from these supportive services to technologies, and the training of health care workers and other staff.
KW - antineoplastic agents
KW - drug regulation
KW - health services accessibility
KW - immunomodulation
KW - price
KW - research design
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U2 - 10.3322/caac.21597
DO - 10.3322/caac.21597
M3 - Review article
C2 - 32068901
AN - SCOPUS:85079715570
VL - 70
SP - 105
EP - 124
JO - Ca-A Cancer Journal for Clinicians
JF - Ca-A Cancer Journal for Clinicians
SN - 0007-9235
IS - 2
ER -