OBJECTIVES: In Algeria, patients' access to hospital innovative drugs is conditioned by their inscription on the commercial list of the Central Hospital Pharmacy (PCH). However, many of cancer and immunology drugs registered since 2017 weren’t inscribed until 2021. This empirical study aims to identify criteria driving the reimbursement decisions and their impact on the delay between obtaining the marketing authorization (MA) and the inscription on the commercial list. For this purpose, oncology and immunology drugs newly added to the commercial list in 2021 were listed.

METHODS: A descriptive analysis was conducted on the characteristics of the collected sample from both public and private sources which only considered the first indication reimbursed. The impact of these criteria on the delay MA-PCH was finally investigated.

RESULTS: Among the cancer drugs, 7 solid and 2 hematologic cancers were identified. 3/4 of immunology drugs were indicated for Multiple Sclerosis. Considering the drugs by their INN, 7/22 had an orphan statute and only 7/22 had no therapeutic alternatives. Almost all drugs had an important SMR. Inversely, different levels of ASMR were found with 9/22 drugs having an ASMR II or III. The delay MA-PCH varied from few months to 4 years with an average of 3 years. A significant disparity was observed in the annual costs per patient going from 10k € to more than 400k € with an average of 80k €.

CONCLUSIONS: Prevalence and costs were identified as the key drivers of these decisions whereas no link appeared between both the existence of alternatives and the level of ASMR and the delay MA-PCH. Finally, it remains challenging to ensure equitable access to these drugs when an economic consideration comes into play. This may suggest that other funding means should be developed to amortize the costs of these innovative drugs.