E-DRUG: World Cancer Day Feb 4: Blog on FT on Cancer report
By Mohga Kamal-Yanni, Oxfam senior health advisor
Gone are the days when cancer was seen as a problem only faced by rich
countries. With the trend of rising cancer rates set to continue because
of changing lifestyles and increasingly ageing populations in developing
nations, cancer is becoming a huge challenge for emerging economies and
the situation is being exacerbated by a lack of affordable medicines.
More than 60 per cent of the world’s new cancer cases occur in Africa,
Asia and Central and South America. These regions account for 70 per cent
of global cancer deaths – over five and a half million lives a year. While
death rates from cancer in wealthy countries are slightly declining
because of early diagnosis and the availability of treatment, this is not
the case is low and middle income countries, where treatment is not widely
available and prevention and early detection programmes are scarce.
The astronomical prices, particularly for newly developed cancer
medicines, have to be paid for in the context of inadequate financing of
health care in most countries. While prices have become unsustainable for
the UK’s National Health Service, in developing countries governments and
individuals struggle to pay for products that are priced at several times
the level of their per capita GDP. This is because when new drugs are
developed and come onto the market, buyers are at the mercy of a single
company without competition.
The companies who hold the drug patents, and therefore dominate the
market, can mark up drugs to make huge profits, even if production costs
are low. When Sanofi dropped the price of ziv-aflibercept – a new drug for
colon cancer – in response to criticism from leading US oncologists, it
highlighted the mysterious ways in which prices are set by pharmaceutical
companies. When patents expire, allowing generic manufacturers to enter
the market, prices can fall by as much as 99 per cent.
The cost of cancer drugs in India is a particularly important example. On
the one hand, the country has a heavy burden – cancer cases are expected
to double there in the next 20 years. On the other hand, India also has
the potential to fix the problem, given its capacity to produce low cost
‘generic’ versions of medicines. For example, an Indian generic version of
sorafenib, a medicine used for advanced liver cancer, costs just three per
cent of what Bayer is charging for its patented version. However, India is
facing huge pressure, especially from the US, that may prevent the
country’s use of legitimate tools to open up markets such as compulsory
licensing, which was used in the case of sorafenib.
A new research paper produced for Oxfam and published today to mark World
Cancer Day, says there are important lessons to learn from the dramatic
drop in the price of HIV/AIDS drugs, which could help to reduce the cost
of cancer medicines. Some HIV drugs have fallen in price from $10,000 per
patient per year to less than $100. The main lesson was that generic
competition is the most effective strategy to reduce prices. Adequate
funding for prevention and treatment programmes also plays an important
role in controlling diseases.
Last month there was widespread UK public concern when the NHS announced
it was having to cut nearly a third of life-prolonging cancer medicines
from its Cancer Drugs Fund because of spiralling costs. The public anger
being felt around NHS drug cuts is a widespread anger being felt by cancer
patients and their families across the globe. In fact, we are all at the
mercy of drug companies’ control of medicines prices. Companies usually
cite the cost of research and development (R&D) as a justification for
high prices. Yet the real cost of R&D remains secret and many dispute this
argument. Even Sir Andrew Witty, the chief executive of GlaxoSmithKline,
described the cost of R&D figure as a “myth”.
Clearly now is the time for global mechanisms to delink the financing of
R&D from the prices of resulting medicines. Otherwise, new effective
medicines will be affordable only for the lucky few.
Mohga M Kamal-Yanni
Senior health & HIV policy advisor, Oxfam GB
John Smith Drive, Oxford, OX4 2JY, UK (GMT, CET-1, EDT+5, EST+6)
UK Mobile + 44 (0)777 62 55 884
Mohga Kamal-Yanni <mkamalyanni@Oxfam.org.uk>