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A National Cancer Grid pooled procurement initiative, India.

C S Pramesh1, Manju Sengar2, Sumedha Patankar2

  • 1Tata Memorial Hospital, Tata Memorial Centre, affiliated with the Homi Bhabha National Institute, Dr Ernest Borges Road, Parel, Mumbai400012, India.

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Summary

Pooled procurement of high-value cancer medicines by the National Cancer Grid in India achieved significant cost savings. This approach improved access to essential oncology drugs, demonstrating the benefits of group negotiation in healthcare systems.

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Area of Science:

  • Health Systems Research
  • Pharmaceutical Procurement
  • Oncology

Background:

  • Decentralized procurement and pricing challenges in low-funded health systems impact access to anti-cancer therapies.
  • Issues include differential pricing, reliance on unverified generics, leading to patient costs and poor outcomes.
  • Pooled procurement offers solutions but requires administrative oversight.

Purpose of the Study:

  • To evaluate the effectiveness of pooled procurement for high-value oncology medicines.
  • To assess cost savings and impact on negotiability through group negotiation.
  • To explore the applicability of this model in other healthcare settings.

Main Methods:

  • The National Cancer Grid piloted pooled procurement for 40 high-value oncology and supportive care drugs.
  • Demand from 23 cancer centers was aggregated, representing 15.6 billion Indian Rupees (US$197 million) at Maximum Retail Price (MRP).
  • Technical and financial evaluations preceded vendor contracts, with savings calculated against MRP.

Main Results:

  • Pooled procurement generated savings of 13.2 billion Indian Rupees (US$166.7 million) compared to MRP.
  • Savings ranged from 23% to 99% (median 82%), with higher savings for generics.
  • Negotiability for high-value oncology medicines was significantly improved.

Conclusions:

  • Group negotiation within pooled procurement effectively reduces costs for high-value medicines.
  • This model enhances access to essential anti-cancer therapies in resource-constrained settings.
  • The approach is transferable to other healthcare systems facing similar procurement challenges.