Scandinavian Working Papers in Economics

IHE Report / IHE Rapport,
IHE - The Swedish Institute for Health Economics

No 2021:3: Cancer care and access to cancer drugs in Asia-Pacific

Thomas Hofmarcher (), George Keel and Peter Lindgren
Additional contact information
Thomas Hofmarcher: IHE - The Swedish Institute for Health Economics
George Keel: IHE - The Swedish Institute for Health Economics
Peter Lindgren: IHE - The Swedish Institute for Health Economics

Abstract: The report explores the state of cancer care and access to cancer drugs in Asia-Pacific. The report is divided into a main report which includes the introduction, the executive summary and the five sub-reports. The sub-reports are also available as separate reports.

14 countries and locations, referred to as “markets” in the report, are included in the analysis. 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 report provides a comparative analysis of the 14 markets. It is divided into five sub-reports focusing on:

1. The burden of cancer: It shows that cancer patient numbers have been growing steadily in recent years along with the incoming silver tsunami. While more and more patients survive cancer in high-income markets, patient outcomes in middle-income markets are at best stagnating.

2. Health spending on cancer care: It shows that most markets miss the informal WHO target of public health spending of 5% of GDP. Cancer accounts for 5-9% of total health spending in high-income markets and only 1-2% (excl. out-of-pocket payments) in some middle-income markets.

3. Patient access to innovative cancer drugs: It shows that there is a big gap between the number of innovative drugs with regulatory approval and those with reimbursement approval. Almost 1 million patient life years are lost for every year of delay in reimbursement of 10 innovative cancer drug-indications across the markets.

4. Health spending on cancer drugs and unmet patient needs: Total health spending on cancer drugs ranges from $30 to $90 per capita in high-income markets and from $0.2 to $6.6 in middle-income markets (based on list prices). Despite higher spending on innovative cancer drugs, even high-income markets may struggle to meet patient needs.

5. Pricing policies for off-patent cancer drugs: Pricing policies for off-patent cancer drugs are not fully effective in many markets. Effective pricing policies for off-patent cancer drugs could free up substantial resources for re-investment in new innovative cancer drugs.

The report was funded by Merck Sharp & Dohme (MSD). Responsibility for the analysis, interpretations, and conclusions, as well as errors or omissions lies solely with the authors.

Keywords: cancer; cancer drugs; Asia; Australia; China; Hong Kong; India; Indonesia; Japan; New Zealand; Malaysia; Philippines; Singapore; South Korea; Thailand; Taiwan; Vietnam; healtheconomics; Health expenditure; Medicines; innovative; unmet patient; generics; biosimilars; patent; pricing; off-patent drugs

196 pages, First version: 2021. Revised: 2021. Earlier revisions: June 4, 2021, 2021, 2021, 2021, 2021, 2021.

Note: The report is divided into a main report which includes the introduction, the executive summary and the five sub-reports. The sub-reports are also available as separate reports.

Full text files

IHE-Report-2021_3a_.pdf PDF-file Full text
IHE-Report-2021_3b_.pdf PDF-file Full text
IHE-Report-2021_3c_.pdf PDF-file Full text
IHE-Report-2021_3d_.pdf PDF-file Full text
IHE-Report-2021_3e_.pdf PDF-file Full text
IHE-Report-2021_3f_.pdf PDF-file Full text
IHE-Report-2021_3g_.pdf PDF-file Full text
IHE-Report-2021_3_.pdf PDF-file Full text

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