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Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey

PURPOSE: Global data mapping access to essential chemotherapeutics for pediatric cancer are scarce. We report a survey of international pediatric cancer care providers’ access to these medicines. METHODS: A Web-based survey was sent to pediatric oncologists registered on the Cure4Kids Web portal. We...

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Autores principales: Cohen, Phillip, Friedrich, Paola, Lam, Catherine, Jeha, Sima, Metzger, Monika L., Qaddoumi, Ibraham, Naidu, Paula, Faughnan, Lane, Rodriguez-Galindo, Carlos, Bhakta, Nickhill
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Clinical Oncology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7010437/
https://www.ncbi.nlm.nih.gov/pubmed/30582430
http://dx.doi.org/10.1200/JGO.18.00150
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author Cohen, Phillip
Friedrich, Paola
Lam, Catherine
Jeha, Sima
Metzger, Monika L.
Qaddoumi, Ibraham
Naidu, Paula
Faughnan, Lane
Rodriguez-Galindo, Carlos
Bhakta, Nickhill
author_facet Cohen, Phillip
Friedrich, Paola
Lam, Catherine
Jeha, Sima
Metzger, Monika L.
Qaddoumi, Ibraham
Naidu, Paula
Faughnan, Lane
Rodriguez-Galindo, Carlos
Bhakta, Nickhill
author_sort Cohen, Phillip
collection PubMed
description PURPOSE: Global data mapping access to essential chemotherapeutics for pediatric cancer are scarce. We report a survey of international pediatric cancer care providers’ access to these medicines. METHODS: A Web-based survey was sent to pediatric oncologists registered on the Cure4Kids Web portal. We queried chemotherapeutics in the WHO Essential Medicines List for Children, from which the average proportional availability was summarized as each country’s access score. In addition, we examined availability of drug packages defined by the WHO-sanctioned Expert Committee for eight pediatric cancers. We undertook a sensitivity analysis investigating how regimen access would change if the cytotoxics specified in recent agreements between the Clinton Health Access Initiative, American Cancer Society, and pharmaceutical companies were universally available. RESULTS: There were significant (P < .001) differences in the median access scores between World Bank income groups, and 42.9% of respondents from low-income and lower middle–income countries reported suboptimal access scores. Our disease-based analysis revealed that 42.1% of patients in low-income and lower middle–income countries lacked full access to chemotherapy packages. Guaranteed availability of the cytotoxics specified in the Clinton Health Access Initiative/American Cancer Society agreements was projected to increase this regimen-based access by 1.6%, although including four additional chemotherapeutics would further increase coverage by 13.9%. CONCLUSION: This study is the first, to our knowledge, to assess worldwide variation in practical access to pediatric chemotherapy. Although mapping the proportion of available chemotherapeutics is informative, we also developed a meaningful estimate of access using disease-specific drug packages. These data provide an important baseline for continued monitoring and can aid in planning adaptive treatment guidelines that consider the trade-offs between access and outcomes.
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spelling pubmed-70104372020-02-12 Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey Cohen, Phillip Friedrich, Paola Lam, Catherine Jeha, Sima Metzger, Monika L. Qaddoumi, Ibraham Naidu, Paula Faughnan, Lane Rodriguez-Galindo, Carlos Bhakta, Nickhill J Glob Oncol Original Report PURPOSE: Global data mapping access to essential chemotherapeutics for pediatric cancer are scarce. We report a survey of international pediatric cancer care providers’ access to these medicines. METHODS: A Web-based survey was sent to pediatric oncologists registered on the Cure4Kids Web portal. We queried chemotherapeutics in the WHO Essential Medicines List for Children, from which the average proportional availability was summarized as each country’s access score. In addition, we examined availability of drug packages defined by the WHO-sanctioned Expert Committee for eight pediatric cancers. We undertook a sensitivity analysis investigating how regimen access would change if the cytotoxics specified in recent agreements between the Clinton Health Access Initiative, American Cancer Society, and pharmaceutical companies were universally available. RESULTS: There were significant (P < .001) differences in the median access scores between World Bank income groups, and 42.9% of respondents from low-income and lower middle–income countries reported suboptimal access scores. Our disease-based analysis revealed that 42.1% of patients in low-income and lower middle–income countries lacked full access to chemotherapy packages. Guaranteed availability of the cytotoxics specified in the Clinton Health Access Initiative/American Cancer Society agreements was projected to increase this regimen-based access by 1.6%, although including four additional chemotherapeutics would further increase coverage by 13.9%. CONCLUSION: This study is the first, to our knowledge, to assess worldwide variation in practical access to pediatric chemotherapy. Although mapping the proportion of available chemotherapeutics is informative, we also developed a meaningful estimate of access using disease-specific drug packages. These data provide an important baseline for continued monitoring and can aid in planning adaptive treatment guidelines that consider the trade-offs between access and outcomes. American Society of Clinical Oncology 2018-11-30 /pmc/articles/PMC7010437/ /pubmed/30582430 http://dx.doi.org/10.1200/JGO.18.00150 Text en © 2018 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/ Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
spellingShingle Original Report
Cohen, Phillip
Friedrich, Paola
Lam, Catherine
Jeha, Sima
Metzger, Monika L.
Qaddoumi, Ibraham
Naidu, Paula
Faughnan, Lane
Rodriguez-Galindo, Carlos
Bhakta, Nickhill
Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title_full Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title_fullStr Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title_full_unstemmed Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title_short Global Access to Essential Medicines for Childhood Cancer: A Cross-Sectional Survey
title_sort global access to essential medicines for childhood cancer: a cross-sectional survey
topic Original Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7010437/
https://www.ncbi.nlm.nih.gov/pubmed/30582430
http://dx.doi.org/10.1200/JGO.18.00150
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