OBJECTIVES: Novel oncology treatments have greatly increased patients’ life expectancy; however, their accessibility always remains a concern. We aimed to analyze how patient access schemes (PAS) affect the accessibility of new, highly effective oncology medications (OMs) in Asia-Pacific (APAC) region.

METHODS: Literature searches were conducted using PubMed and grey literature (online reports, presentations at conferences, nonacademic/indexed journals) until May 2022 to identify the studies highlighting use of PAS in six selected APAC countries. The search strategy utilized terms (alone/in combination) related to ‘risk sharing’, ‘managed entry agreements’, ‘indication value-based pricing’, ‘multiple indication pricing’, ‘patient access schemes’, ‘conditional reimbursement’, ‘oncology’, and ‘neoplasm’. Studies that reported details on PAS for OMs in scoping countries were included, and their impact on access was analyzed.

RESULTS: Out of 215 citations identified from PubMed/grey literature searches, 19 articles met the inclusion criteria and included in final analysis (Australia, n=8; Korea, n=5; China, and Japan, n=3 each; India, and Taiwan, n=1 each). Country specific case study (53%) was the most common study design, followed by comparative analysis (21%), and population-based retrospective analysis (16%). Oncology (in general) was specified in 63% of studies, followed by breast and colorectal (26%), gastric (5%) cancers. In 42% of studies molecules were biologics therapy, whereas 58% did not specify the therapies. Pricing based risk-sharing agreements [RSA] (42%) was the most used PAS type, followed by Government-subsidized co-payment (37%) and outcomes-based RSA (21%). The country with highest experience in using PAS in drug appraisal to increase OMs access was Australia, followed by Korea, Taiwan, and Japan. Whereas, developing nations like China and India have started using PAS for highly priced OMs.

CONCLUSIONS: This review identified the pricing-based RSA as the most practiced PAS in APAC region. All APAC countries practice multiple PAS simultaneously which have enhanced the access of innovative OMs in this region.