Availability of Essential Anticancer Medicines for Children in China

OBJECTIVES: Childhood cancer is a major cause of global childhood mortality, and access to essential anticancer medicines for children are pivotal. We aimed to assess the variation of availability of essential anticancer medicines for children in China from 2018 to 2022 and to explore its influencing factors.

METHODS: We selected 31 essential anticancer medicines for Children from the World Health Organization Model List of Essential Medicines for Children (WHO EMLc). Procurement data from 804 hospitals among 30 provinces in China were used for data analysis. Primary outcome was the availability of essential anticancer medicines in different regions, dosage forms, catalogs, and types of medications.

RESULTS: Twenty-eight medicines were available in China, and the annual mean availability of surveyed medicines increased from 38.57% in 2018 to 58.70% in 2022. The availability of anticancer medicines in China was significantly different across provinces in both 2018 (p=0.047) and 2022 (p=0.027). The mean availability of injectable medicines was significantly higher than that of oral medicines (43.61% vs. 11.69% in 2018, p=0.001; 63.42% vs. 31.61% in 2022, p=0.004). The mean availability of medicines which were included in both National Essential Medicines List in China and WHO EMLc, was significantly higher than that of were included only in WHO EMLc (46.45% vs. 20.82% in 2018, p=0.01; 65.35% vs. 42.70% in 2022, p=0.017). The mean availability of cytotoxic medicines was higher than that of targeted therapy medicines (41.51% vs. 19.36% in 2018, p=0.087; 60.48% vs. 44.10% in 2022, p=0.197). The mean availability of essential anticancer medicine varied between 14.29% for Mercaptopurine and 88.99% for Cyclophosphamide in 2022.

CONCLUSIONS: The availability of essential anticancer medicines for children improved dramatically in public hospitals in China from 2018 to 2022.