Forecasting essential childhood cancer drug need: An innovative model‐based approach

Abstract

BACKGROUND: Childhood cancer outcomes in low-income and middle-income countries have not kept pace with advances in care and survival in high-income countries. A contributing factor to this survival gap is unreliable access to essential drugs. METHODS: The authors created a tool (FOR x ECAST) capable of predicting drug quantity and cost for 18 pediatric cancers. FOR x ECAST enables users to estimate the quantity and cost of each drug based on local incidence, stage breakdown, treatment regimen, and price. Two countryspecific examples are used to illustrate the capabilities of FOR x ECAST to predict drug quantities. RESULTS: On the basis of domestic public-sector price data, the projected annual cost of drugs to treat childhood cancer cases is 0.8 million US dollars in Kenya and 3.0 million US dollars in China, with average median price ratios of 0.9 and 0.1, respectively, compared with costs sourced from the Management Sciences for Health (MSH) International Medical Products Price Guide. According to the cumulative chemotherapy cost, the most expensive disease to treat is acute lymphoblastic lymphoma in Kenya, but a higher relative unit cost of methotrexate makes osteosarcoma the most expensive diagnosis to treat in China. CONCLUSIONS: FOR x ECAST enables needs-based estimates of childhood cancer drug volumes to inform health system planning in a wide range of contexts. It is broadly adaptable, allowing decision makers to generate results specific to their needs. The resultant estimates of drug need can help equip policymakers and health governance institutions with evidence-informed data to advance innovative procurement strategies that drive global improvements in childhood cancer drug access.

Curing pediatric cancer: A global view. Examples from acute lymphoblastic leukemia

“…Real‐world improvements in access to essential drugs, including promising novel therapies, require multilevel and multifactorial solutions comprising (1) national medicine policies aligned with and responsive to iterative updates of the Essential Medicines List for Children; (2) robust procurement and supply management systems to ensure quality and minimize stockouts of essential medical technologies; (3) financing approaches that integrate childhood cancer care into universal health coverage schemes; and (4) national standardization of resource‐adapted treatment guidelines informed by appropriate international best practices. To estimate medication needs, models such as those suggested by Hughes et al 29 . have been developed to help address challenges related to forecasting, and the International Agency for Research on Cancer, together with St. Jude Children’s Research Hospital, launched the Child Global Initiative for Cancer Registry Development (ChildGICR; https://gicr.iarc.fr/child-gicr/) to improve the quality and availability of data on cancer in children, particularly in countries with limited resources, with a more extensive network of registries throughout the six hubs of the GICR.…”

Strengthening access to cancer medicines for children in East Africa: policy options to enhance medicine procurement, forecasting, and regulations

“… Forecasting tools are integrated into national planning for childhood cancer medicines. For example, FORxECAST [ 7 ] can estimate drug quantity and cost for 18 pediatric cancers and is readily adaptable to local health system realities. …”

Strengthening Access to Cancer Medicines for Children in East Africa: Policy Options to Enhance Medicine Procurement, Forecasting, and Regulations

“…forecasting tools are integrated in national planning for childhood cancer medicines. For example, FORxECAST [7] can estimate drug quantity and cost for 18 pediatric cancers and is readily adaptable to local health system realities.…”