Consumption and Expenditure of WHO Essential Medicines for Cancer: Drug Utilization Analysis of 40 Countries and Regions from 2012 to 2022
Author(s)
Yuanshi Jiao, MPH1, Lin Bai, PhD2, Jiaqi Wang, Msc3, Ka Chun Yan, PhD4, Esther W Chan, PhD3, Rong Na, PhD5, David Bishai, PhD6, Guan Xiaodong, MD2, Xue Li, BEc, MPhil, PhD7;
1Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,, Hong Kong, Hong Kong, 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China, 3Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 4Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 5Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 6Division of Health Economics, Policy and Management, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 7Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
1Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,, Hong Kong, Hong Kong, 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China, 3Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 4Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 5Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 6Division of Health Economics, Policy and Management, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, 7Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
Presentation Documents
OBJECTIVES: To address the escalating global cancer burden the World Health Organization introduced the Model List of Essential Medicines (EML) for neoplasm. This multinational drug utilisation study aimed to evaluate international patterns in the consumption and expenditure of EML-listed cancer drugs.
METHODS: We annualised consumption and expenditure data between 2012 to 2022 from MIDAS database, covering 40 economies. We employed the Lorenz curve to visualise the heterogeneity of consumption. Panel regression assessed associations between consumption, income levels, disability-adjusted life-years (DALYs) by neoplasm, Gini index, and the universal health coverage (UHC) service coverage index. We further examined constitutes of consumption and expenditure regarding WHO-documented evidence of overall survival benefits.
RESULTS: By 2022, consumption of essential cancer medicines (standard units per 1 000 capita) was comparable between high- and middle-income economies (median: 431.31 [Interquartile range (IQR): 708.29] vs 605.76 [IQR: 486.15], p-value=0.82). However, per 1 000 capita expenditure disparities were evident (middle-income: USD 3 458.015 [IQR: 2 136.221], high-income: USD 16 890.84 [IQR: 21 878.15], p-value<0.05). Over the 11 years, middle-income economies showed increased consumption (average annual growth rate: 14.2 [IQR: 12.9] %, compared to 1.4[IQR: 5.8] % in high-income) and increased expenditure (average annual growth rate: 7.3[IQR: 15.3] %, compared to -0.4 [IQR:5.4] % in high-income) of essential cancer medicines. Higher UHC service coverage index is significantly associated with increased consumption of EML cancer medicines (estimate: 11.14, 95% Confidence interval [CI]: 6.40-15.87, p<0.05). Furthermore, middle-income economies consumed more medicines with documented overall survival benefits compared to high-income economies (57.2% vs 37.5%, p<0.05).
CONCLUSIONS: Over the past decade, the consumption gap for essential cancer medicines has narrowed, particularly in middle-income economies, where increased access has improved patient outcomes. Improved UHC service coverage drives increased consumption, and middle-income economies prioritise medicines with documented survival benefits.
METHODS: We annualised consumption and expenditure data between 2012 to 2022 from MIDAS database, covering 40 economies. We employed the Lorenz curve to visualise the heterogeneity of consumption. Panel regression assessed associations between consumption, income levels, disability-adjusted life-years (DALYs) by neoplasm, Gini index, and the universal health coverage (UHC) service coverage index. We further examined constitutes of consumption and expenditure regarding WHO-documented evidence of overall survival benefits.
RESULTS: By 2022, consumption of essential cancer medicines (standard units per 1 000 capita) was comparable between high- and middle-income economies (median: 431.31 [Interquartile range (IQR): 708.29] vs 605.76 [IQR: 486.15], p-value=0.82). However, per 1 000 capita expenditure disparities were evident (middle-income: USD 3 458.015 [IQR: 2 136.221], high-income: USD 16 890.84 [IQR: 21 878.15], p-value<0.05). Over the 11 years, middle-income economies showed increased consumption (average annual growth rate: 14.2 [IQR: 12.9] %, compared to 1.4[IQR: 5.8] % in high-income) and increased expenditure (average annual growth rate: 7.3[IQR: 15.3] %, compared to -0.4 [IQR:5.4] % in high-income) of essential cancer medicines. Higher UHC service coverage index is significantly associated with increased consumption of EML cancer medicines (estimate: 11.14, 95% Confidence interval [CI]: 6.40-15.87, p<0.05). Furthermore, middle-income economies consumed more medicines with documented overall survival benefits compared to high-income economies (57.2% vs 37.5%, p<0.05).
CONCLUSIONS: Over the past decade, the consumption gap for essential cancer medicines has narrowed, particularly in middle-income economies, where increased access has improved patient outcomes. Improved UHC service coverage drives increased consumption, and middle-income economies prioritise medicines with documented survival benefits.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR33
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity, Public Spending & National Health Expenditures
Disease
SDC: Oncology