Providing essential medications
December 4, 2020
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Queen鈥檚 University professor in the Department of Oncology Christopher Booth, together with his colleagues, are taking the World Health Organization鈥檚鈥(WHO)鈥痚ssential medicines list (EML) to frontline cancer doctors across the globe.鈥
Every two years since 1977, the WHO鈥痟as鈥痷pdated and released an鈥 and through this list, the WHO aims to promote affordable access to safe and effective medicines and provide guidance for healthcare systems across the world.鈥疶he EML鈥痩ists medicines鈥痵panning鈥痶he鈥痚ntire healthcare spectrum,鈥痺ith one area of focus鈥痓eing鈥痗ancer鈥痗are and treatment.鈥
As part of an ongoing study, Dr. Booth鈥檚 team collected data鈥痶hrough an electronic survey鈥痜rom thousands of doctors worldwide, asking which medications were the most essential.鈥
鈥淭he way that鈥痺e framed the question is: imagine鈥痽our government puts鈥痽ou in charge of鈥痗ancer medicines and tells you that cost is not an鈥痠ssue,鈥痓ut you can only choose ten cancer medicines for your鈥痚ntire鈥痗ountry,鈥濃痵ays鈥疍r. Booth. 鈥淲hat we want to know is鈥痺hich cancer medicines鈥痜ront-line clinicians鈥痺ould鈥痗hoose to derive the 成人大片 public good, and then as a follow up, which of these medicines are actually鈥痑vailable in their country.鈥疘f鈥痶he medicines listed are鈥痭ot available, then the survey follows up by asking why that is.鈥疌reating a list is one thing but it is crucial that we make sure that drugs are actually available on the ground.鈥濃
Dr. Booth adds he hopes this survey will help to identify鈥痬edicines鈥痺hose importance has been overlooked by鈥痚xperts, so that they can be added to鈥痜uture versions of the鈥疎ML.鈥
Another issue that鈥疍r. Booth鈥痠s concerned with is鈥痟ow鈥痑 medicine鈥檚鈥痯rice鈥痗an impact鈥痺hether it is available to patients.鈥疉s鈥痶he survey progresses,鈥痯articipants are asked鈥痶o modify their previous list of essential medicines, but now鈥痜actoring in鈥痗ost.鈥疻hile some medicines鈥痮ffer鈥痓enefits鈥痠n terms of patient outcomes,鈥痶hey鈥痗an be鈥痟ighly expensive. For the EML to be鈥痷seful to鈥痩ow鈥痑nd middle-income countries, it is important to鈥痠dentify鈥痬edicines which offer substantial benefits to patients and are affordable.鈥
鈥淲hile many of the cancer medicines listed on the EML are highly effective low-cost older drugs, there are鈥痵ome oncology drugs on the list鈥痶hat are鈥痸ery鈥痚xpensive. The hope is that by listing these important medicines, countries will be able to better negotiate prices that make them affordable.,鈥 says Dr. Booth.鈥
鈥Having said that,鈥痶here鈥痠s a risk鈥痶o this approach. If鈥痶he cancer list includes too many of these 鈥榲ery high cost鈥 medicines, there is a risk that the Ministry of Health in a country with limited resources may decide the entire cancer list is not practical and decide not to fund any of the EML drugs 鈥 even those that are relatively affordable.鈥濃
The WHO work fits into Dr. Booth鈥檚 broader research program which seeks to improve access and quality of cancer care for patients in Canada and globally.鈥
Ultimately,鈥疍r. Booth says he hopes that鈥痟is research鈥痗ontributes to changes in health policy and clinical practice that鈥lead鈥痶o improved outcomes for patients regardless of where they live.鈥