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Why Southeast Asia Needs to Establish an ASEAN Cancer Center – The Diplomat

Cancer is a growing problem throughout Southeast Asia. According to the latest data from the International Agency for Research on Cancer in 2020, 1 million new cancer patients About 700,000 people died in Southeast Asia. Based on this same database, this number is expected to grow steadily over the next few years, reaching 1.6 million.

But these stats alone don’t tell the whole story. Historically, in much of Southeast Asia, receiving a cancer diagnosis was devastating for patients and their families. In 2015, a landmark longitudinal study that followed 9,513 of her cancer patients across the region found that more than 75% of her patients experienced death or financial ruin. Within 1 year from diagnosisForty-four percent of patients who survived the first year after diagnosis used all of their lifetime savings to pay for treatment.

Take the story of a cancer patient in Cambodia, for example. Own LetraShe was diagnosed with colon cancer in 2017 and chose to go to Thailand for treatment due to the limited treatment options available in her country. Her family ended up spending her over $40,000 on several rounds of chemotherapy in Thailand. Sadly, her treatment was discontinued with the onset of her COVID-19 pandemic, and Retra passed away in November 2020.

Despite these dire economic and health consequences For people in this region, cancer remains a low priority in public health discussions and national health agendas in most Southeast Asian countries. This is an issue that requires all members of the Association of Southeast Asian Nations (ASEAN) to come together and pool resources to address this devastating problem.

Restricted access to anticancer drugs

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Healthcare systems in many Southeast Asian countries face various challenges when it comes to cancer diagnosis and treatment. One particularly pressing issue for ASEAN member states is the lack of access to anticancer drugs. Whether this is due to pure scarcity issues or the high costs associated with these medicines.

2016 global survey base Research reports that access to new drugs is often restricted across Southeast Asia. Lack of accessibility and availability of new drugs has adversely affected patient outcomes in the treatment of common cancers such as breast, colorectal and lung cancers, which together contribute to the death toll in Asia. cause more than one-third of

Thailand and Malaysia Both are considered to have relatively good medical infrastructure. However, cancer patients in these two countries still have limited access to innovative treatments and cutting-edge medicines, while other new treatment paradigms are also limited. It costs the family. For example, researchers found that lack of access to pertuzumab, a monoclonal antibody drug used to treat patients with HER2-positive breast cancer, had a severe impact on patient outcomes in many countries in Southeast Asia. . Without access to the drug alone, the researchers said, 15.7 months loss median survival time.

Meanwhile, Philippines It shows another side of this issue. Although the drugs used to treat HER2-positive breast cancer are technically available on the market, the high cost of these drugs makes them practically inaccessible to most patients.

The shortage of cancer drugs is reported to be the most acute. Myanmar and Malaysia. A major reported barrier to access is the lack of reliable supply of these medicines, especially due to the lack of commercial interest for suppliers to enter and remain in these domestic markets. These barriers limit the ability of cancer patients to receive treatment with new drugs, and when these drugs are available, out-of-pocket costs are generally high.

of Cambodia, Affordable access to chemotherapy drugs remains a challenge, according to Dr. Katherine Tarlock, MD, a volunteer with Health Volunteers Overseas (HVO), a US-based nonprofit program. Dr. Ben Watkins, MD, another HVO program volunteer, said the costs associated with these anticancer drugs often force clinicians to make difficult decisions and prioritize the latest treatment protocols. I explained that I was forced to. Cambodia is too big a financial burden for cancer patients.

Meanwhile, Vietnam, geographical disparities due to the country’s mountainous regions present challenges, making it difficult to distribute chemotherapy drugs and services to rural hospitals. is also a concern. Targeted therapies and the latest drugs to treat certain types of cancer are only available at Hanoi’s National Cancer Hospital, and even with government subsidies, they are not affordable for most Vietnamese.

Minimal funding for cancer control and the high cost of targeted and cytotoxic agents (even when subsidized) are major challenges. Vietnam’s health insurance does not yet cover all costs, especially advanced technology and targeted therapies.

The high demand and limited supply of oncology drugs have also prompted malicious import schemes. placebo, poses a real challenge to the region. In a recent notable example, Former Deputy Minister of Health of Vietnam He was sentenced to four years in prison earlier this year for his role in importing counterfeit cancer drugs into Vietnam.

there may be desire to pursue New mechanisms, current budgetary and policy priorities that may improve access to innovative medicines of high clinical value pose substantial barriers to broader access.Not enough cancer by country evidence-based dataSuch as national cancer burdens and national cancer drug lists in Asian countries that can provide a conceptual framework for ‘correct’ policy making.

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Given the current limitations, ASEAN should seriously consider creating regional cancer centers. This will enable member countries to focus on researching, debating, and connecting with cancer patients in Southeast Asia with accessible and affordable medicines.

What ASEAN Cancer Center Can Do

An increase in cancer cases is projected, but no regional efforts have yet been made to address this challenge head-on. ASEAN cancer centers are needed to address the lack of access to cancer drugs, whether due to lack of markets or high costs.

One of the key roles that ASEAN Cancer Centers can play is as a convener of relevant cancer data from member countries. Evidence-based data will help county and local policy makers design effective national cancer controls. At present, data on cancer incidence, prevalence of different types of cancer and demand for key medicines are limited in most ASEAN countries. As a region, policy makers can more effectively design responses to patient needs if they have access to reliable data on these topics.

For example, policy makers might consider putting high-demand drugs on a national drug list so that patients can spend less on the drugs they need most. Clear data on drug needs also help countries avoid drug shortages. This plays a big role in increasing prices.

ASEAN Cancer Centers can also provide collective bargaining power to negotiate drug prices across the region with pharmaceutical companies, rather than each country negotiating on its own.according to Access Improvement Survey 2019 Regarding healthcare, between 2000 and 2010, most ASEAN countries reported an increase in costs over eight times the international average. In the Philippines, this figure was more than 26 times the average.

there are obviously bigger ones Purchasing power parity gap Among ASEAN countries for anticancer drugs. For example, as of 2017, drugs to treat bone marrow cancer and some lymphomas are priced at $3,622.22 in Malaysia and $4,630.12 in Thailand, while targeted drugs used to treat gastrointestinal cancer are $150.47 in Malaysia and $89.20 in Thailand. This reality further underscores the importance of ASEAN cross-border cooperation, especially in terms of how regional institutions influence drug pricing transparency and price negotiations across the region.

Lessons can be learned from intergovernmental regional cooperation between Belgium, the Netherlands, Luxembourg and Austria (Beneluxua) was created in 2015 to jointly negotiate drug prices and share information across borders to address information asymmetries between purchasers and pharmaceutical companies. Following in BeNeLuxA’s footsteps, Malta, Cyprus, Greece, Italy, Spain and Portugal signed in 2017. Valletta Declarationis a coalition of Southern EU Member States that aims to explore strategies for jointly negotiating prices for new drugs and treatments with the pharmaceutical industry.

Cancer is too big an enemy for any individual government to tackle on its own. Rather, ASEAN should take a cooperative, cross-border approach. The establishment of a dedicated ASEAN Cancer Center has the potential to protect patients and their families and strengthen the region’s capacity to deliver better outcomes for those dealing with this disease.



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