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Abstract：
BACKGROUND: The availability and affordability of safe, effective, high-quality, affordable anticancer therapies are a core requirement for effective national cancer control plans.
METHODS: Online survey based on a previously validated approach. The aims of the study were to evaluate (i) the availability on national formulary of licensed antineoplastic medicines across the globe, (ii) patient out-of-pocket costs for the medications, (iii) the actual availability of the medication for a patient with a valid prescription, (iv) information relating to possible factors adversely impacting the availability of antineoplastic agents and (v) the impact of the country\'s level of economic development on these parameters. A total of 304 field reporters from 97 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer review and amendments have been incorporated into the final report.
RESULTS: Surveys were submitted by 135 reporters from 63 countries and additional peer-review data were submitted by 54 reporters from 19 countries. There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most substantial issues are in lower-middle- and low-income countries. Even among medications on the WHO Model List of Essential Medicines (EML) the discrepancies are profound and these relate to high out-of-pocket costs (in low-middle-income countries 32.0% of EML medicines are available only at full cost and 5.2% are not available at all, and for low-income countries, the corresponding figures are even worse at 57.7% and 8.3%, respectively).
CONCLUSIONS: There is wide global variation in formulary availability, out-of-pocket expenditures and actual availability for most licensed anticancer medicines. Low- and low-middle-income countries have significant lack of availability and high out-of-pocket expenditures for cancer medicines on the WHO EML, with much less availability of new, more expensive targeted agents compared with high-income countries.
METHODS: Online survey based on a previously validated approach. The aims of the study were to evaluate (i) the availability on national formulary of licensed antineoplastic medicines across the globe, (ii) patient out-of-pocket costs for the medications, (iii) the actual availability of the medication for a patient with a valid prescription, (iv) information relating to possible factors adversely impacting the availability of antineoplastic agents and (v) the impact of the country\'s level of economic development on these parameters. A total of 304 field reporters from 97 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer review and amendments have been incorporated into the final report.
RESULTS: Surveys were submitted by 135 reporters from 63 countries and additional peer-review data were submitted by 54 reporters from 19 countries. There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most substantial issues are in lower-middle- and low-income countries. Even among medications on the WHO Model List of Essential Medicines (EML) the discrepancies are profound and these relate to high out-of-pocket costs (in low-middle-income countries 32.0% of EML medicines are available only at full cost and 5.2% are not available at all, and for low-income countries, the corresponding figures are even worse at 57.7% and 8.3%, respectively).
CONCLUSIONS: There is wide global variation in formulary availability, out-of-pocket expenditures and actual availability for most licensed anticancer medicines. Low- and low-middle-income countries have significant lack of availability and high out-of-pocket expenditures for cancer medicines on the WHO EML, with much less availability of new, more expensive targeted agents compared with high-income countries.
摘要：
背景：安全的可用性和可负担性，有效,高品质，负担得起的抗癌疗法是有效的国家癌症控制计划的核心要求。
方法：基于先前验证方法的在线调查。该研究的目的是评估（i）全球许可的抗肿瘤药物的国家处方集的可用性，(ii)患者自付药物费用，（iii）具有有效处方的患者的药物的实际可用性，（iv）与可能对抗肿瘤剂的供应产生不利影响的因素有关的信息，以及（v）国家经济发展水平对这些参数的影响。来自97个国家的304名实地记者应邀参加。初步数据集发布在ESMO网站上，供公开同行审查，修正案已纳入最终报告。
结果：调查由来自63个国家的135名记者提交，其他同行评审数据由来自19个国家的54名记者提交。处方集可用性存在重大差异，许多抗癌药物的自付费用和实际可用性。最严重的问题是中低收入国家。即使在世卫组织基本药物标准清单（EML）上的药物中，差异也很大，这与高自付费用有关（在中低收入国家，32.0％的EML药物仅全额提供，而5.2％根本没有。对于低收入国家来说，相应的数字甚至更糟，分别为57.7%和8.3%，分别)。
结论：处方集的可用性存在很大的全球差异，大多数获得许可的抗癌药物的自付费用和实际可用性。低收入和中低收入国家严重缺乏世卫组织EML癌症药物的可获得性和高自费支出，新的可用性要少得多，与高收入国家相比，目标代理商更昂贵。
方法：基于先前验证方法的在线调查。该研究的目的是评估（i）全球许可的抗肿瘤药物的国家处方集的可用性，(ii)患者自付药物费用，（iii）具有有效处方的患者的药物的实际可用性，（iv）与可能对抗肿瘤剂的供应产生不利影响的因素有关的信息，以及（v）国家经济发展水平对这些参数的影响。来自97个国家的304名实地记者应邀参加。初步数据集发布在ESMO网站上，供公开同行审查，修正案已纳入最终报告。
结果：调查由来自63个国家的135名记者提交，其他同行评审数据由来自19个国家的54名记者提交。处方集可用性存在重大差异，许多抗癌药物的自付费用和实际可用性。最严重的问题是中低收入国家。即使在世卫组织基本药物标准清单（EML）上的药物中，差异也很大，这与高自付费用有关（在中低收入国家，32.0％的EML药物仅全额提供，而5.2％根本没有。对于低收入国家来说，相应的数字甚至更糟，分别为57.7%和8.3%，分别)。
结论：处方集的可用性存在很大的全球差异，大多数获得许可的抗癌药物的自付费用和实际可用性。低收入和中低收入国家严重缺乏世卫组织EML癌症药物的可获得性和高自费支出，新的可用性要少得多，与高收入国家相比，目标代理商更昂贵。
