Economic perspective of cancer treatment in India
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Economic perspective of cancer treatment in India Aparna Natarajan1 · Nikita Mehra1,2 · Thangarajan Rajkumar1 Received: 20 June 2020 / Accepted: 26 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Financial constraints faced by the families play a vital role in cancer treatment refusal, non-adherence, and failure of the prescribed therapy. This review aims to give an insight into the economic perspective of cancer treatment in India, focusing on the accessibility and affordability of oncological drugs, and the move towards generics/biosimilars without compromising on the quality of the treatment. The monthly cost of a set of drugs available in India for the treatment of solid malignancies, approved after 2010 by the US FDA and the Drugs Controller General of India (DCGI) were calculated based on standard patient parameters. The information on the clinical trial, the monthly cost of treatment, and the availability of its equivalent have been compiled. Newer cancer drugs are approved based on surrogate endpoints, with a very modest prolongation of life, but the cost incurred can be unbearable. There is a considerable variation in costs between the innovator and the equivalent drugs, making the latter cost-effective. We have highlighted the importance of generics and biosimilars, as a cost-cutting strategy, in delivering state-of-art health care with a lesser chance of treatment abandonment: this will ensure that all patients have equal access to personalized medicine which are reliable, effective, and affordable for better curative, supportive, and palliative care. Keywords Cancer treatment · Challenges · Cost · Innovator drugs · Generics · Biosimilars
Introduction Cancer treatment is a booming area of research with the breakthrough of a repertoire of personalized anti-cancer agents. However, it emanates with an unsustainable price causing a substantial financial burden, impoverishing families into debt to meet the healthcare expenses. Although this is a global issue, the multi-fold negative impact created is more pronounced in developing countries where there is a surge in the cancer burden. The investment involved in bringing a novel drug into the market is exorbitant due to the innovation, drug development, manufacturing, licensing, patenting, company profits, and also the amounts capitalized in failed drugs [1]. The newer biologics and
* Nikita Mehra [email protected] 1
Department of Molecular Oncology, Cancer Institute (WIA), Dr S Krishnamurthy Campus, 38 Sardar Patel Road, Chennai 600036, India
Department of Medical Oncology, Cancer Institute (WIA), Dr S Krishnamurthy Campus, 38 Sardar Patel Road, Chennai 600036, India
2
immunotherapies have shown significant benefits, but they are prohibitively expensive, unaffordable, and jeopardize accessibility at the consumer end in a developing country like India [2]. The American Society of Clinical Oncology (ASCO) has set up realistic clinical improvements to be achieved by th
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