Comparison of Prices and Affordability of Cancer Medicines in 16 Countries in Europe and Latin America

Abstract

Background: There are concerns that high prices of cancer medicines may limit patient access. Since information on prices for cancer medicines and their impact on affordability is lacking for several countries, particularly for lower income countries, this study surveys prices of originator cancer medicines in Europe and Latin America and assesses their affordability.

Methods: For 19 cancer medicines, public procurement and ex-factory prices, as of 2017, were surveyed in five Latin American (LATAM) countries (Brazil, Chile, Colombia, Mexico, and Peru) and 11 European countries (Austria, France, Germany, Greece, Hungary, the Netherlands, Poland, Romania, Spain, Sweden, and the UK). Price data (public procurement prices in LATAM and ex-factory prices in Europe) in US dollar purchasing power parities (PPP) were analyzed per defined daily dose. Affordability was measured by setting medicines prices in relation to national minimum wages.

Results: The prices of cancer medicines varied considerably between countries. In European countries with higher levels of income, PPP-adjusted prices tended to be lower than in European countries of lower income and LATAM countries. Except for one medicine, all surveyed medicines were considered unaffordable in most countries. In European countries of lower income and LATAM countries, more than 15 days' worth of minimum wages would be required by a worker to purchase one defined daily dose of several of the studied medicines.

Conclusions: The high prices and large unaffordability of cancer medicines call for strengthening pricing policies with the aim of ensuring affordable treatment in cancer care.

Fig. 1

Prices of originator cancer medicines in 11 European countries and five LATAM countries. DDD defined daily dose, LATAM Latin America(n countries), LHIC lower high-income countries, mg milligrams, UHIC upper high-income countries, US$ PPP/DDD price per medicine, adjusted to purchasing power parity (PPP) in US dollars per DDD, country code—see Table 1

Fig. 2

Affordability of originator cancer medicines in 11 European countries and five LATAM countries. day/DDD number of daily minimum wages necessary to buy one DDD, DDD defined daily dose, LATAM Latin America(n countries), LHIC lower high-income countries, mg milligram, UHIC upper high-income countries, country code—see Table 1