Page 0052

T

oday, an individual's odds of surviving cancer are

strongly correlated with where that person lives.

Whereas in the United States the five-year survival

rate for patients with breast cancer is 84%, in the Gambia,

breast cancer survival is just 12.5%. Interestingly, gains in

survival have not always been due to very expensive

treatments. Frequently, increased survival has been

achieved by cancer treatments that are relatively low cost.

Considered for many years a problem almost exclusive to

rich countries, cancer is rapidly becoming a leading cause of

death and disability in poor countries. Currently, low-income

countries have just 5% of resources to deal with 80% of the

global burden (1). In addition to this, the existing treatments

and new therapies are accessible to less than 10% of the

world population.

Cancer drugs - some facts

The 20 leading oncology brands generated global sales just

short of US$ 50 billion in 2012 with an overall expansion of

US$ 63 billion by 2018. In addition, the cost of cancer drugs

has more than doubled in the past decade and, of the 12

cancer drugs approved in 2012 by the FDA for cancer, 11

were priced at more than US$ 100,000 per patient per year.

Innovative cancer drugs are developed with public and

private investment in cancer research. Globally, the

pharmaceutical industry spends US$ 6.5-8 billion per year

on cancer research, but public investment in cancer research

(i.e. governmental and charitable) is at much lower levels

and, frequently, research and development of cancer drugs is

mainly driven by commercial considerations rather than by

public health priorities. America's biopharma research

companies are testing 771 medicines and vaccines to fight

the many types of cancer affecting millions of patients

worldwide and approximately half of the investigated

products in late-stage development are highly sophisticated

therapies. The price of new therapies has been set very high,

and as more new and targeted therapies enter the market

and are used as long-term maintenance therapy, the overall

cost of cancer care will increase significantly. Under the

current circumstances, new therapies will become

unaffordable for many countries, even for the most

developed (2).

An economic perspective

Proper treatment and new therapies not only promise to

enhance the life of patients and increase the quality of

clinical practice but also to lower overall health-care costs

through early detection, prevention, accurate risk

assessments and efficiencies in care delivery. Current

inefficiencies are widely regarded as substantial enough to

have a significant impact on the economies of major nations

and, therefore the world economy. A recent Organisation

for Economic Co-operation and Development (OECD)

report estimates health-care expenditure for some of the

developed western and eastern nations to be anywhere from

10% to 18%, and growing (with the United States at the

highest). This situation has an enormous impact in the

current world economy. In total, from each US$ 10 that are

produced globally, one dollar goes to health (3).

The 2014 World Cancer Leaders' Summit, organized by

TREATMENT COSTS AND

NEW THERAPIES

EDUARDO CAZAP, PAST-PRESIDENT, UNION FOR INTERNATIONAL CANCER CONTROL (UICC),

GENEVA; FOUNDING PRESIDENT, LATIN-AMERICAN AND CARIBBEAN SOCIETY OF MEDICAL

ONCOLOGY (SLACOM), BUENOS AIRES AND EXECUTIVE COMMITTEE, NATIONAL CANCER

INSTITUTE, MINISTRY OF HEALTH, BUENOS AIRES

In this article, the author looks at the whether new treatments and therapies are aligned

to the priorities and finances of lesser-resourced countries. He reviews current opinions on

this subject among leading organizations involved in cancer care and examines the

barriers faced by these countries that exclude from the latest developments.

CANCER MANAGEMENT

50 CANCER CONTROL 2015

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