OBJECTIVES: In Pakistan, as in many parts of the world, access to affordable anticancer medicines is limited due to high out-of-pocket costs. This situation leads to economic hardship and impoverishment. The present study aimed to evaluate the access and affordability of 89 anticancer medicines using the methodology of the World Health Organization (WHO) and Health Action International (HAI).

METHODS: The survey was conducted from May to July 2023 at selected public health facilities and private pharmacies. Availability was measured as the percentage of facilities with treatment stocks on the survey day. Local prices were used to estimate the Median Price Ratio (MPR) using the MSH price guide, and affordability based on the daily wages of the lowest-paid skilled worker ($3.37 per day) to cover one month's cost incurred for cancer treatment.

RESULTS: The findings align with existing evidence, showing only 50% of critical anticancer medicines are available. The results were also compared with neighboring countries such as India, Bangladesh, Sri Lanka, and Nepal, as well as other lower-middle-income countries. The study highlighted significant disparities in pricing variation, affordability and availability of cancer medicines across different countries. The lower price of Anastrozole tablets in India signifies a more affordable option for patients compared to Pakistan and Bangladesh.

CONCLUSIONS: Investment in health systems can improve access to crucial cancer treatments by promoting the indigenous manufacturing of biosimilars and generic alternatives, incorporating Pharmacoeconomics principles for negotiating lower medicine costs, and use in health insurance schemes in alignment with commitments to universal health coverage and cancer care.