Child cancer drugs neither available nor accessible to the poor in Delhi

A study reveals that a lowest-paid government employee will have to spend 55 days’ wages to get a child treated for Hodgkin's lymphoma and 88 days’ for standard risk leukaemia

By Banjot Kaur
Published: Thursday 25 April 2019
Photo: Getty Images

Anti-cancer or chemotherapy drugs for children are cheaper in New Delhi than internationally, but still not cheap enough to be accessible to the poor, according to a study published in journal BMJ Global Health.

The study added that a lowest-paid government worker in the country will have to spend wages he earned over 55 days to buy drugs needed to treat a child suffering from Hodgkin's lymphoma and 88 days for standard risk leukaemia.

“The estimated cost of chemotherapy medicines needed to treat a 30-kg child with standard risk leukaemia was Rs 27,850 and Rs 17,500 for early stage Hodgkin’s lymphoma,” said study collaborator and paediatric oncologist Ramandeep Arora.

“If the patient or his/her family is not offered any discount and has to buy the medicines at MRP, they will require extra 12 days’ wages for both diseases. This will increase significantly if the disease is high-risk,” she added. 

Also, the availability of these drugs in Delhi’s public and private pharmacies do not meet the World Health Organization (WHO) standards. The mean availability of anti-neoplastic essential medicines across hospitals and private-sector retail pharmacies in the Capital was 70 per cent when the WHO availability target is 80 per cent.

“Mean availability of anti-neoplastic medicines was 43 per cent and 71 per cent in public- and private-sector hospital pharmacies,” read the paper titled Evaluating Access to Essential Medicines for Treating Childhood Cancers: A Medicines Availability, Price and Affordability Study in New Delhi, India.

The study was led by the George Institute for Global Health in collaboration with the University of Sydney, Cankids India, Max Super Speciality Hospital, and Boston University School of Public Health.

It added that strength-specific medicines were unavailable in any pharmacy and were only available in alternative doses and strengths. But, those doses and strengths were not on the designated Essential Medical List (EML) of the government.

The researchers said since chemotherapy is administered in hospitals, their pharmacies should ideally stock all the medicines listed in the EML. However, these pharmacies — particularly one in public hospitals — had low mean availability. The possible reasons they listed were poorly managed supply chain, inaccurate medicine demand forecasting and an underfunded public health sector.

But, the private didn’t meet the WHO standards either. Researchers said low demand could be causing this since most private-sector hospitals do not allow patients to purchase medicines from facilities other than the pharmacy in the hospital.

The research also pointed at poor availability of these medicines in Jan Aushadhi Centres. Only three of the surveyed anti-neoplastics were found to be on the list of medicines that are provided by these special-discount pharmacies. “The government should establish an essential cancer medicines review committee to evaluate which additional medicines could be included in such schemes to improve access,” the paper recommended. 

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