Cancer has become a major public health challenge in countries at all income levels. Despite impressive advancements in biomedical research, improved understanding of relevant risk factors and increased survival rates in developed nations, the rising incidence rate (new cases) of cancer is, however, becoming a formidable challenge. The growing burden of cancer illness is projected to increase for several decades due to demographic and epidemiological transitions already ongoing in low- and middle-income countries (LMICs). In addition to the disease burden, patients, caregivers, third party payers (insurance companies and public health authorities), and physicians are also met with the worrisome challenge of rapidly increasing costs of new cancer drugs.
Escalating prices of cancer drugs have evoked concern among stakeholders about the financial burden faced by patients in accessing life-saving treatment. There is now a general consensus that the current model of drug development needs thorough streamlining. Cost-containment strategy calls for addressing the issue of declining R&D productivity trends and reforming the drugs pricing system. Regarding the productivity puzzle, the present study has analyzed both the efficiency and effectiveness aspects of the drug discovery and development process. New suggested approaches for improving efficiency are presented in this document. These include, matching drugs to the patient's molecular profile, "adaptive trial" designs (i.e., using interim analysis to customize the trials), alternative surrogate endpoints, expedited regulatory review procedures, new open models of collaboration, multidisciplinary research on a global scale, and applications of computational biology and bioinformatics advancements. The proposed value-based pricing approach is also reviewed in this study as a means of achieving cost effectiveness.
Patient advocacy group, expressing concerns, have alleged that pharmaceutical companies are using their monopoly power in setting the prices of new anticancer agents. Contemporary pharmaceutical industry pricing practices lack transparency on the company's R&D expenditure data. Soaring prices along with inadequate public funding programs in many countries for catastrophic drug coverage are resulting in an alarming proportion of out-of-pocket (OOP) expenses on life-saving drugs. The majority of the population in LMICs is additionally subjected to severe financial hardship due to poverty, lack of gainful employment and the complete absence of old age income security benefits in many of these countries.
Amid the rising incidence of cancer illness, there is encouraging evidence that much can be done in every country to prevent, cure, and relieve the suffering (WHO 2002). Research has shown that at least 50 percent of cancers are preventable. Countries' experience show that no matter what resource constraints a country faces, a well-conceived, well-managed national cancer control programme is able to reduce cancer incidence and improve the lives of people living with cancer (WHO 2002). Science backed evidence suggests an important role of diet factors, such as a high intake of vegetables and fruits as a component of daily diet in containing the risks of cancer. These prevention efforts warrant attention beginning at prenatal and nascent years and continue through all life stages.
