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Availability and affordability of anticancer medicines in Iran based on WHO/HAI standard survey methods

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Abstract

Purpose

Cancer is the second leading cause of death in the world after cardiovascular disease. The present study aimed to investigate the affordability and physical access to chemotherapy drugs among patients with one of the three common cancers of the breast, stomach, and colon in the city of Mashhad, Iran, in 2021.

Methods

This was a descriptive cross-sectional study. Twenty drug stores including two public and 18 privates in Mashhad were evaluated. Data was collected by consistent stay in the drug stores or pharmacies. For each oncology medicine, selling price, lowest general price, and availability were investigated. Three approaches have been experimented to calculate the affordability of anticancer medicines in this study.

Results

Out of 28 studied medicines from public and private drug stores, 15 (53.5%) received very low, 8 (28.5%) relatively high, and 2 (7%) high access scores. The generic docetaxel brand’s ultra-drug and trastuzumab (AryoTrust) were the most available drugs, but the doxorubicin (Ebewe), oxaliplatin (Mylan), and trastuzumab (Herceptin) were not available to the individuals with cancer. Also, the first approach (based on income decile) indicated that insured patients from all income deciles were able to pay the costs of the lowest price drugs of the DCF drug regimen, and if the patients were insured and belonged to the ninth income decile, they had the financial ability to buy drugs at the lowest price of the FLO drug regimen.

Conclusion

Unaffordability of cancer medicines can lead to treatment abandonment and increase inequality in access to healthcare services. Therefore, this requires immediate attention of policy makers to be planned in order to ensure to reducing the costs of medicines for patients and increasing patient access to anticancer medicines.

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Data Availability

All data are available upon reasonable request from the first author.

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Acknowledgements

The authors would like to thank Dr. Elham Heidari for proofreading the manuscript and providing suggestions for improvements.

Funding

This study is financially supported by Mashhad University of Medical Sciences with project number 990419.

Author information

Authors and Affiliations

  1. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Mehdi Varmaghani

  2. Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

    Sepideh Elyasi

  3. Department of Clinical Pharmacy and Pharmacoeconomics, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran

    Mohammad M. Mojahedian

  4. Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

    Vahid Ghavami

  5. Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

    Behnam Borhani

  6. Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

    Javad Javan-Noughabi & Shirin Sarafraz

Authors
  1. Mehdi Varmaghani
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  2. Sepideh Elyasi
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  3. Mohammad M. Mojahedian
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  4. Vahid Ghavami
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  5. Behnam Borhani
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  6. Javad Javan-Noughabi
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  7. Shirin Sarafraz
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Contributions

All authors contributed in conception and design, acquisition of data, analysis, and interpretation of data. The first draft of the manuscript was written by Mehdi Varmaghani and Javad Javan-Noughabi. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Javad Javan-Noughabi or Shirin Sarafraz.

Ethics declarations

Ethics approval and consent to participate

This paper is extracted from the research project approved by Mashhad University of Medical Sciences with project number 990419. Also, the study has been approved by the Ethics Committee of Mashhad University of Medical Sciences with the code of IR.MUMS.FHMPM.REC.1400.005. All methods were carried out per relevant guidelines and regulations.

Consent for publication

Consent for publication is not applicable as this study did not include names, images, or videos relating to individual participants.

Competing interests

The authors declare no competing interests.

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Varmaghani, M., Elyasi, S., Mojahedian, M.M. et al. Availability and affordability of anticancer medicines in Iran based on WHO/HAI standard survey methods. Support Care Cancer 31, 89 (2023). https://doi.org/10.1007/s00520-022-07546-w

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