Patient access to innovative cancer drugs in Asia-Pacific

Hofmarcher T, Keel G, Lindgren P

Den tredje delrapporten i rapportserien om cancer och cancerläkemedel i Asien och Stillahavsområdet belyser patienternas tillgång till innovativa cancerläkemedel.

It describes patient access to innovative cancer drugs and its consequences for patients in 14 countries and locations (called “markets” in the report) in Asia-Pacific. They are grouped into 7 high-income markets (Australia, Hong Kong, Japan, New Zealand, Singapore, South Korea, Taiwan) and 7 middle-income markets (China, India, Indonesia, Malaysia, the Philippines, Thailand, Vietnam).

The sub-report provides a comparative analysis of the 14 markets. The main findings are:

1. Access to innovative cancer drugs (with ESMO-MCBS score of 4/B+) through reimbursement is quite limited. Of 38 innovative drug-indications approved by the US FDA in treatment of five major cancer types, 80% had received regulatory approval across Asia-Pacific in 2020. Yet only 35% of those indications were also reimbursed in 2020.

2. High-income markets achieve much higher proportions of both regulatory approval and reimbursement approval rates (91% and 59%, respectively) than middle-income markets (68% and 17%, respectively).

3. China, Indonesia, and Vietnam approve relatively fewer indications but at the same time reimburse a higher proportion of them. Japan sticks out due to its policy to reimburse all approved drugs essentially by default, which stands in stark contrast to the restrictive reimbursement policy observed in New Zealand.

4. Timely reimbursement of innovative cancer drugs is a major challenge in all markets except in Japan. In high-income markets along with China, the median delay between regulatory approval and reimbursement approval was around 1.5 to 3 years. In all middle-income markets except China, delays could not be assessed, because there are essentially no recent innovative indications that have ever achieved reimbursement listing.

5. The lack of timely reimbursement of innovative cancer drugs results in a great loss of patient life years. For every year of delay in reimbursement, almost 1 million patient life years are lost across Asia-Pacific, drawing on a limited sample of only 10 innovative drug-indications.

6. Reasons for delayed reimbursement of innovative cancer drugs vary. In middle-income markets, they relate more to limited public health budgets as well as the organization of the reimbursement process with listings being infrequently reviewed and updated. In high-income markets, they relate more to the criteria applied in the reimbursement process and the lack of fast-track systems for innovative drugs.

Merck Sharp & Dohme (MSD) har bidragit med finansiering av denna rapport. Det är författarna ensamma som svarar för analys, tolkningar och rapportens innehåll.

Tidigare utgivna rapporter i rapportserien om cancer och cancerläkemedel i Asien och Stillahavsområdet:

Cancer care and access to cancer drugs in Asia-Pacific – Introduction
IHE Report 2021:3a, IHE: Lund, Sweden

Cancer care and access to cancer drugs in Asia-Pacific – Executive summary
IHE Report 2021:3b, IHE: Lund, Sweden

Download the report