Broader Access to Paediatric Cancer Drugs

Mar 29, 2012
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Philippines: Improved access to treatment for paediatric cancer, a leading cause of death in children aged 1-14.

1221 Eight out of 10 children under the age of 15 in the Philippines who have cancer, die. PHOTO: Jason GutierrezAn NGO-government partnership in the Philippines has improved access to treatment for paediatric cancer, a leading cause of death in children aged 1-14, according to the Department of Health (DOH).

“The first results suggest that our programme has raised the survival rate for childhood ALL [acute lymphoblastic leukaemia] from 20 to 50 percent. To achieve this, we addressed two issues: the high price of medicines in the country, and unaffordable out-of-pocket payments for families,” Pia Cayetano, a parliamentarian, told IRIN in the capital region of Metro Manila.

There are 3,500 cancer cases in children younger than 15 each year in the Philippines, and around half of them are ALL, a cancer that affects the blood and bone marrow, according to the Manila-based NGO Cancer Warriors Foundation, Inc. (CWFI). 

Nationwide, eight of every 10 children with paediatric cancer died in 2008 (a total of 2,800 deaths). “The first obstacle to saving more children from ALL in the Philippines was the prices of drugs - among the highest in Asia,” said Carmen Vallejo Auste, co-founder of CWFI.

Management Sciences for Health, an NGO based in Boston in the US, studied the prices paid for 42 essential cancer medicines in 2010 by the governments of low- and middle-income countries. For 10 of the medicines, some governments paid as much as 10 times more than others did, while for 23 more drugs some governments paid double the price compared to others. 

The wide price variations were caused preferential deals offered by drug companies to buyers who were able to negotiate lower prices.

The Philippines is in a region that has some of the world’s highest of out-of-pocket costs to patients, according to the World Health Organization (WHO).

In 2009, the government passed a law that put a price ceiling on 21 of the essential medicines on the WHO list of these drugs. 

The government also successfully negotiated with drug companies, bringing down by 50-75 percent the prices of nine paediatric chemotherapy drugs used to treat ALL, and the savings were passed on to patients.

According to the DOH, 14 public hospitals have provided these medications at no cost to children with ALL since 2009.

“CWFI’s role was to collect and disseminate information about health issues, to instigate negotiation between all the actors of the health sector, and to provide limited financial support,” said Auste.

Childhood cancers are relatively rare, representing around 3 percent of all cancers in the country’s general population, but they are among the top three killers of children aged 5-14.

Worldwide, every year there are 175,000 new childhood cancer cases in youngsters under the age of 15, and 96,000 deaths, according to the US National Cancer Institute (NCI).

Childhood cancers are often very different from those seen in adults, and the NCI says the causes are largely unknown.

What is known is their burden on the often overstretched health care systems of developing countries,  where some 55 percent of 12.7 million new cancer cases and 64 percent of 7.6 million cancer deaths occurred in 2008, according to the Harvard-based initiative, Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries.

This article was first published in IRIN.