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. 2022 Nov 4:10:980969.
doi: 10.3389/fpubh.2022.980969. eCollection 2022.

Accessibility of essential anticancer medicines for children in the Sichuan Province of China

Zhe Chen  1   2   3   4   5 , Siyu Li  1   2   3   4   6 , Kun Zou  1   2   3   4 , Hailong Li  1   2   3   4 , Linan Zeng  1   2   3   4 , Xiaoxi Lu  4   7 , Zhi-Jun Jia  1   2   3   4   5 , Guo Cheng  4   7   8 , Lingli Zhang  1   2   3   4
Affiliations

Accessibility of essential anticancer medicines for children in the Sichuan Province of China

Zhe Chen et al. Front Public Health. .

Abstract

Background: Compared with high-income countries, the survival rate of childhood cancer is lower in low- and middle-income countries. Access to essential anticancer medicines is an indispensable component of pediatric cancer treatment, which is still a big challenge in low- and middle-income countries.

Objective: To assess the accessibility of essential anticancer medicines for children in public hospitals in the Sichuan Province of China.

Methods: Based on the data of the Sichuan Province Drug Use Monitoring Platform in 2020, a retrospective study was conducted to investigate the original brands and generics of 34 anticancer and three supportive essential medicines for children (a total of 97 specific strengths) in Sichuan Province. The availability, price, and affordability of surveyed medicines were evaluated in all 152 tertiary public hospitals (120 general hospitals, 31 children's hospitals, and one cancer hospital) that could diagnose and treat cancer for children.

Results: The average availability of generics and original brands was 18.5% and 2.6%, respectively. In regions with different gross domestic product (GDP) per capita levels, the average availability was similar, but the city with lower GDP per capita levels had fewer tertiary public hospitals. The prices of most original brands were higher than the lowest-priced generics, and the median price ratios of 31 lowest-priced generics and 16 original brands were 0.744 (P25~P75, 0.446~2.791) and 2.908 (1.719~6.465). After paying medical insurance for medicines, the affordability of essential anticancer medicines was improved. The monthly medicine cost did not exceed 10% of the monthly household income for 78.9% (30/38) of the lowest-priced generics and 50.0% (8/16) of the original brands.

Conclusion: The availability of lowest-priced generics was higher than original brands in public hospitals, but the availability of both was low, which was similar to previous studies in low- and middle-income countries. About half of the lowest-priced generics and 87.5% of the original brands cost more than 1.5 times the International Reference Price. Although the National Basic Medical Insurance greatly improved the affordability of essential anticancer medicines for children, higher subsidies for essential medicines for cancer treatment to limit catastrophic health expenditures are still recommended.

Keywords: accessibility; affordability; anticancer medicine; availability; child; essential medicine; price.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer JP declared a shared affiliation with the authors to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Average availability of originator brands and generics in different cities of Sichuan Province.
Figure 2
Figure 2
Comprehensive comparison of the availability and affordability of children's essential anticancer medicines in the public hospitals in Sichuan Province. (A) Before medical insurance reimbursement_generics; (B) before medical insurance reimbursement_original brands; (C) after medical insurance reimbursement_generics; (D) after medical insurance reimbursement_original brands.
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References

    1. Global Burden of Disease Compare Visualizations . Available online at: https://www.thelancet.com/lancet/visualisations/gbd-compare (accessed January 11, 2022).
    1. Steliarova-Foucher E, Fidler MM, Colombet M, Lacour B, Kaatsch P, Piñeros M, et al. . Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991-2010 (Automated Childhood Cancer Information System): a population-based study. Lancet Oncol. (2018) 19:1159–69. 10.1016/S1470-2045(18)30423-6 - DOI - PMC - PubMed
    1. Rodriguez-Galindo C, Friedrich P, Alcasabas P, Antillon F, Banavali S, Castillo L, et al. . Toward the cure of all children with cancer through collaborative efforts: pediatric oncology as a global challenge. J Clin Oncol. (2015) 33:3065–73. 10.1200/JCO.2014.60.6376 - DOI - PMC - PubMed
    1. Magrath I, Steliarova-Foucher E, Epelman S, Ribeiro RC, Harif M, Li CK, et al. . Pediatric cancer in low-income and middle-income countries. Lancet Oncol. (2013) 14:e104–16. 10.1016/S1470-2045(13)70008-1 - DOI - PubMed
    1. Zhang X. Chapter 11: Causes of Residents' Sickness and Death. Beijing, China: China Statistical Yearbook, Peking Union Medical College Press. (2019). p. 279–309.

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