Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India
Introduction Limited access to essential medicines (EMs) for treating chronic diseases is a major challenge in low-income and middle-income countries. Although India is the largest manufacturer of generic medicines, there is a paucity of information on availability, price and affordability of anti-n...
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| Format: | Article |
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BMJ Publishing Group
2019-03-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/2/e001379.full |
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| author | Rohina Joshi Neha Faruqui Alexandra Martiniuk Abhishek Sharma Chanchal Sharma Bhumika Rathore Ramandeep Singh Arora |
| author_facet | Rohina Joshi Neha Faruqui Alexandra Martiniuk Abhishek Sharma Chanchal Sharma Bhumika Rathore Ramandeep Singh Arora |
| author_sort | Rohina Joshi |
| collection | DOAJ |
| description | Introduction Limited access to essential medicines (EMs) for treating chronic diseases is a major challenge in low-income and middle-income countries. Although India is the largest manufacturer of generic medicines, there is a paucity of information on availability, price and affordability of anti-neoplastic EMs, which this study evaluates.Methods Using a modified WHO/Health Action International methodology, data were collected on availability and price of 33 strength-specific anti-neoplastic EMs and 4 non-cancer EMs. Seven ‘survey anchor’ hospitals (4 public and 3 private) and 32 private-sector retail pharmacies were surveyed. Median price ratios (MPRs) were calculated by comparing consumer prices with international reference prices (IRPs).Results On average, across survey anchor areas (hospital and private-sector retail pharmacies combined), the mean availability of anti-neoplastic EMs and non-cancer medicines was 70% and 100%, respectively. Mean availability of anti-neoplastic EMs was 38% in private-sector retail pharmacies, 43% in public hospital pharmacies and 71% in private hospital pharmacies. Median MPR of lowest-priced generic versions was 0.71 in retail pharmacies. The estimated cost of chemotherapy medicines needed for treating a 30 kg child with standard-risk leukaemia was INR 27 850 (US$442) and INR 17 500 (US$278) for Hodgkin’s lymphoma, requiring 88 and 55 days’ wages, respectively, for the lowest paid government worker.Conclusion Most anti-neoplastic EMs are found in survey anchor areas, however, mean availability was less than non-cancer medicines; not meeting the WHO target of 80%. Medicine prices were relatively low in New Delhi compared with IRPs. However, the cost of chemotherapy medicines seems unaffordable in the local context. |
| format | Article |
| id | doaj-art-1bc56e0940d648ad9ba54331f96215d6 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-1bc56e0940d648ad9ba54331f96215d62024-12-15T04:40:08ZengBMJ Publishing GroupBMJ Global Health2059-79082019-03-014210.1136/bmjgh-2018-001379Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, IndiaRohina Joshi0Neha Faruqui1Alexandra Martiniuk2Abhishek Sharma3Chanchal Sharma4Bhumika Rathore5Ramandeep Singh Arora68 George Institute for Global Health, Delhi, Delhi, IndiaSchool of Public Health, University of Sydney, Sydney, New South Wales, AustraliaThe George Institute for Global Health, Sydney, New South Wales, Australia2 Medicine, Watford General Hospital, Watford, UKIndependent researcher, New Delhi, IndiaCankids NGO, New Delhi, IndiaCankids NGO, New Delhi, IndiaIntroduction Limited access to essential medicines (EMs) for treating chronic diseases is a major challenge in low-income and middle-income countries. Although India is the largest manufacturer of generic medicines, there is a paucity of information on availability, price and affordability of anti-neoplastic EMs, which this study evaluates.Methods Using a modified WHO/Health Action International methodology, data were collected on availability and price of 33 strength-specific anti-neoplastic EMs and 4 non-cancer EMs. Seven ‘survey anchor’ hospitals (4 public and 3 private) and 32 private-sector retail pharmacies were surveyed. Median price ratios (MPRs) were calculated by comparing consumer prices with international reference prices (IRPs).Results On average, across survey anchor areas (hospital and private-sector retail pharmacies combined), the mean availability of anti-neoplastic EMs and non-cancer medicines was 70% and 100%, respectively. Mean availability of anti-neoplastic EMs was 38% in private-sector retail pharmacies, 43% in public hospital pharmacies and 71% in private hospital pharmacies. Median MPR of lowest-priced generic versions was 0.71 in retail pharmacies. The estimated cost of chemotherapy medicines needed for treating a 30 kg child with standard-risk leukaemia was INR 27 850 (US$442) and INR 17 500 (US$278) for Hodgkin’s lymphoma, requiring 88 and 55 days’ wages, respectively, for the lowest paid government worker.Conclusion Most anti-neoplastic EMs are found in survey anchor areas, however, mean availability was less than non-cancer medicines; not meeting the WHO target of 80%. Medicine prices were relatively low in New Delhi compared with IRPs. However, the cost of chemotherapy medicines seems unaffordable in the local context.https://gh.bmj.com/content/4/2/e001379.full |
| spellingShingle | Rohina Joshi Neha Faruqui Alexandra Martiniuk Abhishek Sharma Chanchal Sharma Bhumika Rathore Ramandeep Singh Arora Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India BMJ Global Health |
| title | Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India |
| title_full | Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India |
| title_fullStr | Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India |
| title_full_unstemmed | Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India |
| title_short | Evaluating access to essential medicines for treating childhood cancers: a medicines availability, price and affordability study in New Delhi, India |
| title_sort | evaluating access to essential medicines for treating childhood cancers a medicines availability price and affordability study in new delhi india |
| url | https://gh.bmj.com/content/4/2/e001379.full |
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