The need to make cancer drugs affordable

Source: The post is based on the article “The need to make cancer drugs affordable” published in The Hindu on 22nd December 2022. 

Syllabus: GS2 – Issues related to the development and management of health 

Relevance: About the high cost of cancer treatment

News: The article explains the issue of the high cost of cancer treatment in India. 

What are some facts related to the high cost of cancer treatment in India? 

The Rajya Sabha Standing Committee on Health noted that “about 40% of cancer hospitalisation cases are financed mainly through borrowings, sale of assets and contributions from friends and relatives”.  

This situation has arisen because even average out of pocket spending on cancer care is too high. Spending on cancer care in private facilities is about three times that of public facilities.  

According to WHO, the costs associated with other medical care and interventions such as surgical interventions and supportive care would make overall care even more unaffordable. 

In the treatment protocol for breast cancer, CDK (cyclin-dependent kinase) inhibitors constitute a major therapeutic tool. These three drugs belong to this therapeutic class. A month’s treatment using these drugs could range between ₹48,000 and ₹95,000. 

What are the impacts of the high cost of cancer treatment? 

The high treatment cost has seriously impacted survival rates in developing countries. In the case of breast cancer, the five-year survival rate in India is estimated to be 65%. In high-income countries, it is nearly 90%. 

The lack of access to these critical medicines has pushed the life of patients and their families into deep financial stress. It has affected their right to live with dignity, a fundamental right guaranteed under Article 21 of the Indian Constitution.  

The Supreme Court in several judgments has interpreted the right to health as an extension of the right to life under Article 21. According to the WHO Constitution, “enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being”. 

What explains the high cost of cancer treatment? 

Recover research and development cost: According to pharmaceutical companies, they spend over $3 billion bringing a new molecule to the market. They must recover these costs. 

However, the WHO observed that spending on research and development may bear little or no relationship to how pharmaceutical companies set cancer medicine prices. Companies set prices with an eye to maximise profits. 

Intellectual property protection: The pharma companies can exercise monopoly control over their products.  

The scope and the power of these monopolies can become nearly absolute due to several factors. Ordinarily, patent rights over a medicine last until the expiry of its patent term. 

In the case of pharmaceutical patents, the leading firms in the industry often obtain patents on incremental innovations involving older medicines. It is called evergreening. 

What is the way forward to overcome the high cost of cancer treatment? 

The most obvious option is to authorise Indian companies to domestically produce high-priced cancer medicines, by granting compulsory licences in keeping with Sections 84 and 92 of the Patents Act. 

The Government can invoke provisions of Section 100. It empowers the government to authorise any entity to use a patented invention without the authorisation of the patent holder. According to the Rajya Sabha’s Standing Committee on Health, invoking the provisions of Section 100 seems to be the best way forward.