# Availability, price and affordability of anticancer medicines in Jiangsu Province, China: a cross-sectional survey study

## TL;DR

This study assesses the availability, price, and affordability of anticancer medicines in Jiangsu Province, China, finding that generic drugs are more accessible and affordable than newer, innovative medicines.

## Contribution

The study provides a cross-sectional survey of anticancer medicine availability and affordability in Jiangsu Province, highlighting disparities between generic and innovative drugs.

## Key findings

- Generic anticancer medicines were more available and affordable than innovative ones.
- Availability of anticancer medicines in hospitals was higher than in community pharmacies.
- Innovative anticancer medicines were significantly more expensive than in European countries.

## Abstract

To evaluate anticancer medicines’ availability, price and affordability in nine prefecture-level cities, Jiangsu Province.

Based on the standard methods recommended by the World Health Organization (WHO) and the Health Action International (HAI), a cross-sectional survey was performed to collect information about 24 essential anticancer medicines (EAMs) and 17 innovative anticancer medicines (IAMs) in hospitals and 45 community pharmacies in Jiangsu Province from July to November 2021.

In general, the availability of EAMs during the study period was higher than that of IAMs, and the availability of the Lowest-priced generics (LPGs) was higher than that of the originator brands (OBs). Anticancer medicines in hospitals were more available than those in community pharmacies. Specifically, the availability of anticancer medicines positively correlated with different cities’ economic status. However, there were no significant changes in the availability of IAMs among different cities. The median price ratio (MPR) value of OBs was greater than that of LPGs, and both were greater than one. There were no significant changes in the MPR value of EAMs among different economic regions (p > 0.05). The price of IAMs was significantly greater than the median price of 18 European countries. There were significant changes in the affordability of EAMs and IAMs among different cities (p < 0.05). In this research context, IAMs had poor affordability, but LPGs had good affordability for the residents. The affordability of urban residents was better than that of rural residents.

The availability of anticancer medicines in community pharmacies was low, especially in intravenous anticancer preparations. The Chinese government formulated a dual-channel policy to improve the availability of anticancer medicines in community pharmacies. However, implementing the dual-channel policy required the effective interaction and cooperation of the hospitals, community pharmacies, medical insurance, and other departments. The price of IAMs was still the main obstacle to receiving treatment for cancer patients; therefore, the government should further optimize the price of IAMs through various strategies to achieve a reasonable price. Expanding the coverage of EAMs was conducive to improving treatment affordability for cancer patients.