Dose optimisation to improve access to effective cancer medicines

Area of Science:

• Oncology
• Pharmacoeconomics
• Global Health

Background:

• Access to essential cancer medicines is limited in low- and middle-income countries (LMICs) due to high costs.
• Approved cancer drug doses and schedules often exceed affordability in LMICs, hindering access to life-saving therapies.
• Immune checkpoint inhibitors for lung cancer are examples of vital medicines not on the WHO Essential Medicines List (EML) due to cost.

Purpose of the Study:

• To explore strategies for reducing cancer medicine costs and improving access in LMICs.
• To investigate the potential for optimizing approved dosing regimens and treatment schedules.
• To demonstrate that reduced-intensity cancer treatments can maintain therapeutic efficacy while lowering costs.

Main Methods:

• Reviewing evidence from randomized clinical trials, dose-finding studies (Phase 1 and 2), and pharmacokinetic/pharmacodynamic studies.
• Analyzing regulatory approval data for cancer medicines, including dosing and schedules.
• Evaluating the impact of optimized regimens on cost-effectiveness, toxicity, and patient outcomes.

Main Results:

• Optimized dosing and schedules can achieve near-equivalent therapeutic outcomes compared to standard regimens.
• Reduced-intensity treatments lead to significant price reductions and improved cost-effectiveness.
• Lower doses and less frequent schedules can decrease toxicity and enhance patient quality of life.

Conclusions:

• Identifying and implementing optimized cancer treatment regimens is crucial for improving global access to essential medicines.
• Clinicians and policymakers should prioritize reduced-intensity treatments that maintain efficacy.
• This approach enhances affordability, reduces side effects, and increases survival benefits, particularly in resource-limited settings.