Asia-Pacific analysis of ESMO study on availability, out-of-pocket costs (OPC) and accessibility of antineoplastic medicines

BACKGROUND: The European Society for Medical Oncology (ESMO) conducted a global survey on the availability, out-of-pocket costs (OPCs), and accessibility of cancer medicines in 2015, with an updated survey in 2023. The Asia-Pacific (APAC) region accounts for approximately half of global cancer-related deaths, yet substantial disparities persist in access to essential cancer medicines. A focused analysis of the 2023 ESMO global survey was undertaken to evaluate access trends specific to the APAC region. PATIENTS AND METHODS: Data from the 2023 ESMO global survey were analysed to assess the availability, access, and OPC of cancer medicines in APAC countries, using the World Health Organization's Essential Medicines List as a benchmark. Countries included in the analysis were Australia, Taiwan (China), Japan, New Zealand, Republic of Korea, Singapore, China, Malaysia, Thailand, Bangladesh, Cambodia, India, Indonesia, Mongolia, Myanmar, Nepal, Papua New Guinea, Philippines, Vanuatu, and Vietnam. Selected case studies, including immunotherapy and oral targeted therapies, were used to explore access and regulatory approval timelines. A descriptive comparison of health technology assessment processes across APAC countries was also conducted. RESULTS: Availability and access to antineoplastic medicines in APAC remain limited, particularly in low- and middle-income countries. Although novel therapies are generally available, they often incur substantial OPC burdens on patients. The case studies reveal considerable delays in regulatory approval for both immunotherapy and targeted therapies across the region. CONCLUSIONS: Despite the introduction of innovative cancer therapies, substantial inequities in access and availability persist across APAC. Coordinated regional policies and streamlined regulatory processes may improve equitable access in the region.