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A pilot study revealed large differences in median retail prices for 23 cancer drugs in seven different countries, with the highest retail prices identified in the United States and the lowest in India and South Africa. Notably, after monthly drug price is expressed as a percentage of domestic product per capita at purchasing power parity (GDPcapPPP), cancer drugs appear to be less affordable in low-income countries, despite the lower retail prices. The study was featured in at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.

?This study provides a glimpse into prices and affordability of cancer drugs around the world and sets the stage for further research,? said lead study author Daniel A. Goldstein, MD, a senior physician in medical oncology at Rabin Medical Center in Petach Tkvah, Israel.?However, the implications of our findings are limited because we were not able to take discounts and rebates into account, which would better predict drug affordability, Goldstein added?

About the Study
According to the authors, this is one of the largest analyses of differences in cancer drug prices between countries worldwide. Prior research in this field has been sporadic and based on reports on single drugs in only a few countries or regions.

The researchers calculated monthly drug doses for 15 generic and eight patented cancer drugs used to treat a wide range of cancer types and stages. Retail (list) drug prices in Australia, China, India, South Africa, United Kingdom, Israel, and the United States were obtained predominantly from government websites.

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GDPcapPPP is a measure of national wealth that takes into consideration the cost of living. The GDPcapPPP data for each country was obtained from the International Monetary Fund and researchers used it to estimate the affordability of drugs.

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Key Findings
The median monthly retail price ranged from $1,515 in India to $8,694 in the U.S. for patented drugs. For generic drugs, the median monthly retail price was the highest in the United States ($654) and lowest in South Africa ($120) and India ($159).

In terms of ability to pay, cancer drugs appeared to be most affordable in Australia, with monthly drug prices of 3% of GDPcapPPP for generics and 71% of GDPcapPPP for patented drugs. The countries with the lowest ability to pay were China and India. In China the monthly price of generics was 48% of GDPcapPPP and 288% for patented drugs. In India, the cost of generics was 33% of GDPcapPPP and the cost of patented drugs 313% of GDPcapPPP. In the U.S., the cost of generics was 14% of GDPcapPPP and cost of patented cancer drugs was 192% of GDPcapPPP.

The study did not take into account the health insurance systems in different countries. Depending who is purchasing the medication in a given country, either the government, insurance company, or the patient may suffer the brunt of the burden of financial toxicity.

?There are significant differences in drug prices across different countries, but even more important is that increasing prices are putting a significant burden on patients. More needs to be done to make treatments affordable and accessible for all patients,? said Patricia Ganz, MD, an ASCO Expert.

This study was unfunded.

Last editorial review: July 12, 2016.

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