• Document: A global comparison of the cost of patented cancer drugs in relation to global differences in wealth
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www.impactjournals.com/oncotarget/ Oncotarget, 2017, Vol. 8, (No. 42), pp: 71548-71555 Research Paper A global comparison of the cost of patented cancer drugs in relation to global differences in wealth Daniel A. Goldstein1,2, Jonathon Clark1, Yifan Tu3, Jie Zhang4, Fenqi Fang4, Robert Goldstein5, Salomon M. Stemmer1,6,* and Eli Rosenbaum1,* 1 Davidoff Cancer Center, Rabin Medical Center, Petach Tikvah, Israel 2 Winship Cancer Institute, Emory University, Atlanta, GA, USA 3 Saint Louis University Hospital, St. Louis, MO, USA 4 First Affiliated Hospital of Dalian Medical University, Dalian, China 5 University College London, London, UK 6 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel * These authors contributed equally to this work Correspondence to: Daniel A. Goldstein, email: dgolds8@emory.edu Keywords: cost, affordability Received: February 13, 2017     Accepted: March 16, 2017     Published: May 09, 2017 Copyright: Goldstein et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT Introduction: There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Results: Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. Materials and Methods: We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Conclusions: Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies. INTRODUCTION While the cost and value of cancer drugs have recently gained considerable attention, an additional The cost of cancer drugs is under intense scrutiny. factor of economic importance must be considered – Drug prices at market launch in the United States have namely affordability. The high cost of cancer drugs places increased significantly in recent years [1], however a financial burden on both society as well as patients prices alone should not be considered in isolation from and their families. In the United States, individuals clinical benefit. Perhaps more important is the concept diagnosed with cancer are 2.7 times more likely to of value which can be measured using cost-effectiveness declare bankruptcy, than individuals without cancer [6]. analyses. While the value of some cancer drugs is high, Cost, value and affordability of cancer drugs vary around recent studies have demonstrated that some cancer drugs the world. While the clinical benefit of a cancer drug is provide low value [2, 3]. Value frameworks have also been usually similar around the world, other economic factors developed by professional cancer societies to provide may vary significantly. Drug prices are known to be the guidance to patients, physicians and policy-makers [4, 5]. highest in the United States with lower prices around www.impactjournals.com/oncotarget 71548 Oncotarget the world [7, 8]. There is wide variation in both national benefits scheme [10]. For China, we used the Chinese and personal wealth around the world, thus impacting Government Pharmacy Information Website [11] in affordability of cancer dr

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