A global comparison of the cost of patented cancer drugs in relation to global differences in wealth

// Daniel A. Goldstein 1, 2 , Jonathon Clark 1 , Yifan Tu 3 , Jie Zhang 4 , Fenqi Fang 4 , Robert Goldstein 5 , Salomon M. Stemmer 1, 6, * and Eli Rosenbaum 1, * 1 Davidoff Cancer Center, Rabin Medical Center, Petach Tikvah, Israel 2 Winship Cancer Institute, Emory University, Atlanta, GA, USA 3 Saint Louis University Hospital, St. Louis, MO, USA 4 First Affiliated Hospital of Dalian Medical University, Dalian, China 5 University College London, London, UK 6 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel * These authors contributed equally to this work Correspondence to: Daniel A. Goldstein, email: dgolds8@emory.edu Keywords: cost, affordability Received: February 13, 2017      Accepted: March 16, 2017      Published: May 09, 2017 ABSTRACT Introduction: There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Results: Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. Materials and Methods: We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Conclusions: Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies.