• According to recent estimates, globally cancer cases will increase from 19.3

million to 28.4 million by 2040.

• In, India tobacco use accounts for almost 50% of all cancers.
• High incidence of tobacco related cancer was found in the north eastern region.
• In this context, it is important to keep check on availability of prevention and affordable treatment options.

High cost of Cancer treatment

Cost of cancer care

• Cancer care facilities in private is thrice costlier than the public facilities.
• About 40% of cancer hospitalization cases are financed mainly through borrowings, sale of assets and contributions from friends and relatives.
• As per WHO, cost associated with medical care and intervention and supportive care is more unaffordable in developing countries.

Example: Cost of breast cancer treatment

• In case of standard treatment for breast cancer: The cost is equivalent to about 10 years of average annual wages in India and South Africa and 1.7 years in US.
• In case of other medical (such as radiotherapy) and supportive care: The cost of medicine is completely unaffordable.
• For the treatment of breast cancer, one of the three drugs, Ribociclib, Palbociclib and Abemaciclib is required for lifetime.
• Current monthly cost for patient in India for such drug is between 47,000 to 95,000 INR.

Reason for such high prices

1. High R&D Cost

• Pharmaceutical companies argue that they spend over $3 billion in bringing a new molecule to the market.
• WHO report mentioned that spending on R&D may bear little or no relationship to how pharmaceutical companies set cancer medicine prices.

2. Intellectual Property Rights (IPR)

• IPR allows companies to sustain their high profit margins, which results into high prices.
• Example: Pfizer’s holds rights of Palbociclib till 2023, while Novartis’s Ribociclib and Elly Lilly’s rights on Abemaciclib will end between 2027 and 2029.
• Till then, no Indian company can manufacture these medicines.

Recommendation for reduction in cancer treatment

Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PM-JAY)

• PM-JAY beneficiaries’ get yearly 5 lakh health cover for secondary and tertiary health care.
• It should be expanded to include diagnostic tests and other services for cancer care.

Reduction in margins

• National Pharmaceutical Pricing Authority (NPPA) fixes, revises and monitors the prices of scheduled drugs under National List of Essential Medicines (NLEM).
• Government should reduce profit margins from 16% as it is high or provide subsidy.
• Also 10% annual increment allowed in the prices of non-scheduled drugs should be reduced to 5%.

Granting Compulsory Licenses

• Under Section 84 and 92 of Patents Act, government should grant compulsory license (CLs) to Indian companies for domestic production of high-priced medicines.
• It overrides patent rights and enables domestic manufacturing of generic alternatives of patented high price medicines.
• Government can invoke Section 100 which empowers any entity to use patented invention without authorisation of patent holder.

Other Recommendation

• Focusing on complaint against tobacco consumption.
• Formulate strategies to stop the teenage population from getting addicted to tobacco.
• Raise awareness about cervical cancer.
• Include Human Papilloma Virus (HPV) vaccine against cervical cancer in governments vaccination programme.

Cancer cases will increase from 19.3 million to 28.4 million by 2040. Thus, it is important to provide cancer care and medication in affordable price otherwise it impacts on the life of a patient which violates the ‘Right to life with dignity’ under Article 21 of the constitution.