Enhancing global access to cancer medicines

Javier Cortes, Jose Manuel Perez-García, Antonio Llombart-Cussac, Giuseppe Curigliano, Nagi S. El Saghir, Fatima Cardoso, Carlos H. Barrios, Shama Wagle, Javier Roman, Nadia Harbeck, Alexandru Eniu, Peter A. Kaufman, Josep Tabernero, Laura García-Estévez, Peter Schmid, Joaquín Arribas

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish
Pages (from-to)105-124
Number of pages20
JournalCA Cancer Journal for Clinicians
Issue number2
Publication statusPublished - Mar 1 2020


  • antineoplastic agents
  • drug regulation
  • health services accessibility
  • immunomodulation
  • price
  • research design

ASJC Scopus subject areas

  • Hematology
  • Oncology


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