Access to innovative medicines in a middle-income country: The case of Mexico and cancer medicines

  • Daniela Denisse Moye Holz

    Research output: ThesisThesis fully internal (DIV)

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    Abstract

    Access to Innovative Medicines in a Middle-Income Country. The Case of Mexico and Cancer Medicines
    Daniela Denisse Moye Holz
    24 April 2019 at 16.15 hours

    Cancer has become a major cause of mortality worldwide. Low- and middle-income countries working towards universal health coverage are starting to include cancer coverage. Some innovative cancer medicines have become essential medicines, but their high costs pose challenges to health systems. We analyzed how an emerging economy - Mexico - addresses access to innovative essential cancer medicines through a pharmaceutical policy analysis and an assessment of access to such medicines.

    The main strategy of Mexico to improve access to innovative medicines in the public sector is price negotiations. The number of negotiated medicines increased from 2010-2016. Overall, actual prices of medicines paid by health institutions have decreased but they have not become uniform. The procurement of innovative cancer medicines in the public sector has increased, suggesting better access. However, access has been unequal across insurance schemes and geographical regions. Furthermore, the average availability of cancer essential medicines remains below international recommendations. Some prices of cancer medicines are lower than in other countries of the region. Yet essential cancer medicines remain unaffordable to many patients. Healthcare professionals reported that the availability of cancer medicines was sufficient, but that they also encountered medicine shortages, poor public insurance coverage, and lack of resources.

    Improving equitable access to innovative medicines will improve cancer care. Therefore, health systems in emerging economies working towards universal health coverage should develop comprehensive strategies on access to essential innovative medicines. These strategies should be embedded in a national pharmaceutical policy supporting other efforts to strengthen the health system.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    Supervisors/Advisors
    • Hogerzeil, Hendrik, Supervisor
    • Reijneveld, Menno, Supervisor
    • van Dijk, Jitze, Co-supervisor
    Award date24-Apr-2019
    Place of Publication[Groningen]
    Publisher
    Print ISBNs978-94-034-1533-8
    Electronic ISBNs978-94-034-1532-1
    Publication statusPublished - 2019

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