April 20, 2021

The career of oncological drugs triggers prices and inequality | Society

The career of oncological drugs triggers prices and inequality | Society



The frenetic race of the pharmaceutical industry To develop new cancer treatments, start to acquire bubble dyes. This is alerted, without mentioning the word, a report presented by the general director of the World Health Organization (WHO), Tedros Ghebreyesusla, at the 144th meeting of his Executive Board. The work, while recognizing the progress made in oncology, draws a scenario dominated by an unstoppable upward spiral of resources for research, prices and budgets of health systems absorbed by treatments whose real benefits on the health of the population are not always contrasted. The WHO concludes that it is necessary that pharmacies and governments review in full the system of pricing to avoid that drugs are becoming less accessible and accessible to patients.

Two ideas permeate the beginning of the report: cancer remains one of the "greatest challenges" for global public health -9.6 million deaths and 18.1 million new diagnoses in 2018- and the impact on the population is very unequal. While "more than 80% of children with cancer in rich countries manage to be cured", in those with medium and low incomes that percentage "is 10%".

Some differences that high costs threaten to aggravate if governments and industry fail to agree on new pricing policies, since "the current have not led to results in line with the proposed political and economic objectives". "The prices and costs of several cancer medicines often exceed tens of thousands of dollars [y euros] a year per patient ", amounts" much higher "to the money destined" to treat other diseases ".

The WHO also focuses on the lack of review of the actual effectiveness of some drugs. "Despite improvements in health, survival, quality of life and patient care model" achieved with some treatments, "the literature indicates that a considerable proportion of targeted therapies that have been approved in the last 15 or 20 years only show improvements in secondary objectives [como el tamaño del tumor] without improving survival or quality of life. "

Even in those drugs with limited benefits, the WHO questions whether its high cost is justified: "Some drugs show only small benefits, with an average survival of three months, marginal according to experts."

The report is committed to a regulatory framework because "the lack of effective and consistent policies over time can result in an uncontrolled and very dispersed evolution of the prices set by the same medicine against cancer" according to countries, regions and hospitals. The report highlights in this point that "even in countries that have adopted measures to contain drug prices, they have continued to grow significantly in the last decades in the case of new treatments against cancer."

The WHO also calls for avoiding a race between countries by offering all the drugs available in the market. "This will not result in substantial improvements in terms of health, but it will significantly increase spending." "Governments should take into account their specific situation, meeting the needs of the population and the available economic resources."

The report points to pharmaceutical companies for the price escalation and denies that they are justified by the "costs of research and development of new medicines." "These have little or no relation to the way companies set the prices of oncological medicines," concludes WHO, which highlights "the lack of transparency" that prevails in an area where "confidential agreements" are frequent. between governments and laboratories when setting "prices and discounts". All this, the report continues, hinders the "development of long-term policies" that contain the rise.

"Excessive returns"

Part of the problem, for the WHO, are the "excessive financial returns" achieved by laboratories for some drugs, which has fueled a kind of career in which companies "take decisions of excessive risk despite the limited chance of success" in the development of new drugs. This has pushed up the research costs, which in turn is used by the sector as an argument to justify the high prices.

For WHO, however, it is not entirely true for four reasons. The first is that "the price of these medicines has little or no relation to the costs of research and development". The second is that "the income obtained is already high". The third, "a decrease in revenues due to lower prices would be overcome by an increase in sales volume". Finally, the report highlights, part of these research costs "are assumed by governments and non-profit organizations, which have made substantial contributions to the development of new drugs through direct financing or other incentives."

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