Time to Reimbursement in Kazakhstan for Novel Cancer Medicines Approved during the Period 2013-2022

OBJECTIVES:

Cancer is the second leading cause of death globally accounting for more than half of deaths in middle-income countries. The current problematic situation has dramatic disparities in outcomes exist among patients with cancer worldwide owing, in part, to the lack of access to novel cancer medicines. The objective of this study was to assess the availability of novel cancer medicines in Kazakhstan.

METHODS:

We collected novel cancer medicines (ATC code L01 and L02) approvals that were marketed in the past decade in Kazakhstan, using the Registry of Approved Medicines. The primary outcomes were the rate of availability and the time to availability for Kazakhstan. The time to availability, measuring the average time between marketing authorization and availability, using days from the date of marketing authorization to the day of completion of reimbursement approval administrative processes.

RESULTS:

Of 129 novel cancer medicines approved from January 2013 to December 2023, 31 (24%) obtained full availability in Kazakhstan, after listing in National Outpatient Medicines Benefit List and National Medicines Procurement List, with an average time to availability of 35.4 months (1 062 days). Additionally, 73 (56%) cancer medicines had limited availability, due to inclusion in the Kazakh National Formulary, with an average time to availability of 25.5 months (764 days). Limited availability meant being able to specific subpopulations of approved indication or individual patients.

CONCLUSIONS:

Even if with delays of time to availability, the majority of novel cancer medicines obtain the reimbursement in Kazakhstan. Unfortunately, most of them receive only limited availability. Several reasons may exist, including the extra financial burden, differences in market attractiveness because of prevalent intellectual-property protection regimes, the size and sophistication of the potential market of consumers, regulatory controls on medicines pricing and the reimbursement policies.