Procurement of medicines to treat cancer, 2015–2020, China

Abstract

Objective To assess the procurement of medicines to treat cancer in China. Methods We conducted a descriptive analysis of the national procurement data for 20 anti-cancer medicines in China from 2015 to 2020. We estimated the number of defined daily doses procured per year in three areas of China for essential medicines and medicines for targeted therapies. We adjusted the data by the number of cancer patients in each region for each year. Findings Between 2015 and 2020, the number of defined daily doses per patient decreased from 40.87 to 35.86 (−12.27%) for essential medicines, while the number increased from 0.85 to 12.52 (1381.15%) for target medicines. The procurement of three out of 10 essential medicines decreased, whereas procurement of all 10 targeted medicines increased. In 2020, the eastern area procured the most essential medicines (44.98 doses per patient) and targeted medicines (16.55 doses per patient), but had the smallest relative change in procurement of both essential medicines (−22.76%) and targeted medicines (978.16%). The central area had the largest increase in procurement of both essential medicines (9.64%; from 25.25 to 27.68 doses per patient) and targeted medicines (4587.81%; from 0.23 to 10.64 doses per patient). Conclusion Procurement of anti-cancer medicines varied across regions. Specific policies are needed at the national level to eliminate inequalities in access to these medicines. Two issues that need attention are the lower access to many essential anti-cancer medicines in some provinces and the increase in use of targeted medicines.

Access to Essential and Innovative Anti-cancer Medicines: A Longitudinal Study in Nanjing, China

“…Due to highly individualized treatment schedules, WHO doesn't assign DDD for topical medications, serums, vaccines, anticancer medicines, allergen extracts, general and local anesthetics, and contrast agents [22] . We used the daily dose in the medicine's product information for the main treatments as a reference, due to the absence of a DDD for an anti-cancer medicine [11] .…”

“…Most EAMs (OBs) and IAMs are expensive, and the prices of these two types of drugs are generally high and unaffordable in many similar studies [11,20,53,54] . The reason for the overall downward trend of the prices of the two types of drugs may be related to the implementation of the NDPN policy in China since 2016 [53] .…”

“…Another national study focusing on procurement data found that the procurement of three out of 10 EAMs decreased, whereas the procurement of 10 targeted cancer medicines increased between 2015-2020 [11] . A study on EAMs for children showed that the availability of OBs and LPGs was 2.6% and 18.5% [12] .…”

“…(i) Only a limited number of IAMs were examined, especially for the data on availability and affordability. (ii) Little is known about the accessibility of anti-cancer medicines in eastern China since 2016, where the incidence of cancer diseases is highest among different regions during 2015-2020 [11] , as with higher levels of population aging. (iii) The comparison between essential medicines and innovative medicines for cancer diseases still awaits further investigation.…”

“…A previous study surveyed the availability of 32 EAMs in the Hubei Province of China and found that on average availability of OBs in tertiary and secondary hospitals was 13.7% and 6.67%, respectively, whereas that of LPGs was relatively higher, at 62.83% and 42.92%, respectively [9] . In addition, a study aimed to evaluate the change in accessibility of EAMs from 2015 to 2018 in Anhui, China, all IAMs are unaffordable, but their affordability is on the rise [10] .Another national study focusing on procurement data found that the procurement of three out of 10 EAMs decreased, whereas the procurement of 10 targeted cancer medicines increased between 2015-2020 [11] . A study on EAMs for children showed that the availability of OBs and LPGs was 2.6% and 18.5% [12] .…”