The political economics of cancer drug discovery and pricing

Taylor, David G.

doi:10.1016/j.drudis.2020.09.007

Cited by 11 publications

(5 citation statements)

References 31 publications

(36 reference statements)

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“…This price is often the result of R&D costs plus a margin to ensure an acceptable level of profitability for the manufacturers 13 . Even a small improvement in survival time gives laboratories enough leverage to demand astronomical prices even when the drugs have not required significant investment in research and development 14 .The NCCP policy of reducing purchase prices by 50% has certainly reduced them considerably. However, it was reported that they remain well above the prices of private pharmacies.…”

Section: Discussionmentioning

confidence: 99%

Access to Medicines Strategies of the National Cancer Control Programme in Cameroon

et al. 2021

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Objective: Access to cancer drugs is a public health concern in low and middle-income countries. In Cameroon, the National Cancer Control Programme (NCCP) faces various obstacles to ensure accessibility of cancer drugs. This research aims to analyse the strategies implemented by the NCCP to ensure drugs selection and supply chain management,and obstacles encountered at the central level. Methodology: A qualitative cross-sectional situational analysis was carried out at the NCCP and the National Essential Medicines Supply Central (NEMSC)in Yaounde. For this purpose, tape-recorded interviews were conducted with key informants using two interview guides. After transcription, the verbal data were kept in a textual corpus and rendered in verbatim. The content analysis was done manually on the basis of a dimension matrix. SPSS version 20 was used to determine descriptive parameters like frequencies and means. Results: 47% of the drugs retained were part of the National list of essential medicines. The NEMSC ordered 13 princeps. Among these, 35% had generics on the market. In logistics chain management, drug needs estimation and supply planning were based on approximation. As there was no sure information trackability and coordination between actors, not ensured. Also, a monitoring and evaluation plan had not been put in place. Furthermore, the only source of funding was the Government through the annual budget line. Limited financial resources allocated to supply was the main bottle neck, due to the high cost of the therapies and the ever-increasing demand. This resulted in a long stock-out(up to 15 months) for all the drugs and complete unavailability for others, like morphine, despite its great palliative care demand. Conclusion: There are many challenges around cancer drugs accessibility in Cameroon. Therefore it is an urgent need to strengthen drug provision services within the NCCP. Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 4 October, Available online: 15 November 2021 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, alyahawipharm@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, drmmziqbal@gmail.com Similar Articles: EVALUATION OF CURRENT SCENARIO OF CANCER DISEASE AT CHATTAGRAM IN BANGLADESH TREATMENT OF PATIENTS WITH ADVANCED CANCER FOLLOWING CHEMOTHERAPY AND TRADITIONAL MEDICINE - LONG TERM FOLLOW UP OF 75 CASES

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Section: Discussionmentioning

confidence: 99%

Access to Medicines Strategies of the National Cancer Control Programme in Cameroon

et al. 2021

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“…The study cut-off date was selected to provide sufficient follow-up time to track indication approvals after the initial approval. The scope of the study was restricted to multi-indication medicines used in oncology, a therapeutic area that is a) of high interest to decision-makers given burden of disease, high treatment costs and challenges in evidence development [ 14 ] and b) increasingly subject to follow-on indication [ 1 ]. The study scope is also restricted to multi-indication monotherapy treatments to limit the impact of combination therapies.…”

Section: Methodsmentioning

confidence: 99%

Launch sequencing of pharmaceuticals with multiple therapeutic indications: evidence from seven countries

Mills

Michaeli

Miracolo

et al. 2023

BMC Health Serv Res

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Background New medicines are increasingly being identified as efficacious across multiple indications. The impact of current pricing and reimbursement policies on launch decisions across these indications remains unclear. Objective This paper, first, maps marketing authorisation and HTA coverage recommendation sequences of multi-indication medicines across Germany, France, England, Scotland, Canada, Australia, and the USA, and, second, evaluates the clinical characteristics, clinical development time and coverage recommendation time of multi-indication medicines, drawing comparisons between the first and subsequent indications of an approved molecule. Methods Medicine approvals by the Food and Drug Administration between 2009–2019 were screened to identify multi-indication products with approved oncology indications. Data on clinical trial characteristics, clinical performance and HTA outcomes were extracted from publicly available regulatory approval and HTA reports. Results Relative to subsequent indications, first indications were more likely to receive conditional marketing authorisation, have an orphan designation, have a single arm phase II pivotal trial and lower MCBS score. Subsequent indications had faster HTA coverage recommendation times in England and Canada. While the majority of first indications received HTA coverage recommendations across all settings, the proportion of subsequent indications with HTA coverage recommendations was lower and uptake varied considerably across settings. Conclusions Discordance in the value of first versus subsequent indications can pose major challenges in systems that define price based on the initial indication. Current pricing and reimbursement systems generate significant fragmentation in the approval and availability of multi-indication products across settings.

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“…A primary aim of pharmaceutical policy is to promote timely, equitable, affordable and sustainable access to effective medicines [9]. Policy makers must balance the shortterm goal of promoting widespread access to currently available treatment with long-term global R&D priorities and the need to develop further treatments for diseases with unmet need [26]. Value-based pricing, or ensuring the price paid for a medicine reflects the value it provides, falls at the intersection of these two objectives.…”

Section: Barriers To Implementa On Of Ibpmentioning

confidence: 99%

Healthcare Payer Perspectives on the Assessment and Pricing of Oncology Multi-Indication Products: Evidence from Nine OECD Countries

Mills

Kanavos

2023

PharmacoEconomics Open

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Background New pharmaceuticals are increasingly being developed for use across multiple indications. Countries across Europe and North America have adopted a range of different approaches to capture differences in the value of individual indications. Objective The three aims of this study were (i) to review the price-setting practice over the past 5 years for multi-indication products across England, France, Italy, Spain, Belgium, Switzerland, Turkey, Canada and the USA; (ii) to assess the impact of current practices on launch strategy; and (iii) to identify issues in the implementation of indication-based pricing. Methods Ten current and former members of health insurance organisations, healthcare payer organisations or health technology assessment agencies with expertise on pharmaceutical purchasing were invited to participate in semi-structured interviews. Interview transcripts were imported into NVivo 12 for thematic analysis. Results The majority of countries studied require full assessments upon launch of a new indication. Five different approaches to pricing were identified: weighted pricing, differential discounting, mandatory discount, price anchoring and free pricing. Manufacturers show a tendency to launch first in niche indications with high unmet need to achieve a high price. Stakeholders from England, France, Italy, Belgium and Switzerland consider their current system fit for purpose, while other countries expressed concern over the administrative burden of monitoring products at indication level. Conclusions Given the high administrative burden, it is questionable whether indication-based pricing would provide additional public benefit above and beyond current weighted dynamic single pricing and differential discounting practices for multi-indication products.

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The political economics of cancer drug discovery and pricing

Cited by 11 publications

References 31 publications

Access to Medicines Strategies of the National Cancer Control Programme in Cameroon

Access to Medicines Strategies of the National Cancer Control Programme in Cameroon

Launch sequencing of pharmaceuticals with multiple therapeutic indications: evidence from seven countries

Healthcare Payer Perspectives on the Assessment and Pricing of Oncology Multi-Indication Products: Evidence from Nine OECD Countries

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