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.
References
Prasad V, De Jesus K, Mailankody S. The high price of anticancer drugs: origins, implications, barriers, solutions. Nat Rev Clin Oncol. 2017;14:381–90.
Rajkumar T. Cancer immunotherapy: an impossible dream for the common man? Indian J Med Paediatr Oncol. 2020;41:312–6.
Ellis LM, Bernstein DS, Voest EE, Berlin JD, Sargent D, Cortazar P, et al. American society of clinical oncology perspective: raising the bar for clinical trials by defining clinically meaningful outcomes. J Clin Oncol. 2014;32:1277–80.
Haitsma G, Patel H, Gurumurthy P, Postma MJ. Access to anti-cancer drugs in India: is there a need to revise reimbursement policies? Expert Rev Pharmacoecon Outcomes Res. 2018;18:289–96.
Vokinger K, Hwang T, Grischott T, Reichert S, Tibau A, Rosemann T, et al. Prices and clinical benefit of cancer drugs in the USA and Europe: a cost-benefit analysis. Lancet Oncol. 2020;21:664–70.
Report of national cancer registry programme. 2020. https://www.ncdirindia.org/All_Reports/Report_2020/resources/NCRP_2020_2012_16.pdf
Babar Z-U-D, Hussain R, Hasan S. Medicine prices in Asia–Pacific Countries. In: Medicine Price Surveys, Analyses and Comparisons: Evidence and Methodology Guidance. Elsevier Academic Press; 2020. p. 45–60.
Pramesh CS, Badwe RA, Borthakur BB, Chandra M, Raj EH, Kannan T, et al. Delivery of affordable and equitable cancer care in India. Lancet Oncol. 2014;15:e223–e233.
Prinja S, Chauhan AS, Karan A, Kaur G, Kumar R. Impact of publicly financed health insurance schemes on healthcare utilization and financial risk protection in india: a systematic review. PLoS ONE. 2017;12:e0170996.
Prashant Kumar S, Shalini S (2020) What is the cost of cancer care in India?.https://nicpr.icmr.org.in/
Goldstein DA, Clark J, Tu Y, Zhang J, Fang F, Goldstein R, et al. A global comparison of the cost of patented cancer drugs in relation to global differences in wealth. Oncotarget. 2017;8:71548–55.
Kolasani BP, Malathi DC, Ponnaluri RR. Variation of cost among anti-cancer drugs available in Indian market. J ClinDiagn Res. 2016;10:FC17–20.
Adwal S, Baghel R. Price variation in different brands of anticancer drugs available in Indian pharmaceutical market: a cost analysis study. Int J Basic ClinPharmacol. 2019;8:642.
Gupta N, Verma RK, Gupta S, Prinja S. Cost effectiveness of trastuzumab for management of breast cancer in India. JCO Glob Oncol. 2020;6:205–16.
Gupta N, Verma RK, Prinja S, Dhiman RK. Cost-effectiveness of sorafenib for treatment of advanced hepatocellular carcinoma in India. J Clin Exp Hepatol. 2019;9:468–75.
Mukhopadhyay A, Das S, Sharma K, Dash S. Estimating the economic burden of cancer at a tertiary public hospital: a study at the all India Institute of Medical Sciences. Discuss Pap Econ. 2011;11–09
World Health Organization Model List of Essential Medicines, 21st List. 21st ed. Geneva: World health organization; 2019. https://www.who.int/medicines/publications/essentialmedicines/en/
Rushvi P, Charmy K, Choudhary Nirav CPN. Biosimilars: an emerging market opportunities in India. Pharm Regul Aff. 2016;05:1–7.
Meher B, Balan S, Mohanty R, Jena M, Das S. Biosimilars in India; current status and future perspectives. J Pharm Bioall Sci. 2019;11:12–5.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Natarajan, A., Mehra, N. & Rajkumar, T. Economic perspective of cancer treatment in India. Med Oncol 37, 101 (2020). https://doi.org/10.1007/s12032-020-01424-3
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s12032-020-01424-3