New agreements to increase access to cancer medicines and save countless lives

Reviewed by Emily Henderson, B.Sc.Jun 29 2020

The American Cancer Society (ACS) and the Clinton Health Access Initiative (CHAI) today announced agreements with pharmaceutical companies Pfizer, Novartis, and Mylan to expand access to 20 lifesaving cancer treatments in 26 countries in sub-Saharan Africa and Asia. Purchasers are expected to save an average of 59 percent for medicines procured through the agreements.

"With the rapidly growing burden of cancer in Africa, it is crucial that we improve and expand access to high-quality, affordable treatment. These agreements build on those announced in 2017 that have already delivered substantial savings and increased treatment availability in several countries, including Nigeria. By targeting the treatment needed for the cancers that cause the most deaths, these new agreements will help us to improve on quality of lives and close the mortality gap for Africans with cancer," said Professor Isaac Adewole, co-chair, African Cancer Coalition and former Health Minister of Nigeria.

Medications included in the agreements cover recommended regimens for 27 types of cancer and enable complete chemotherapy regimens for the three cancers that cause the most deaths in Africa--breast, cervical, and prostate. These cancers are highly treatable and account for 38 percent of cancers in the countries covered in the agreements. The new agreements include both chemotherapies and endocrine therapies aligned to evidence-based guidelines harmonized for sub-Saharan Africa, and expand access to additional formulations, including those essential for treating childhood cancer.

With cancer cases increasing at such a rapid rate in sub-Saharan Africa, access to affordable cancer treatment that meets the quality standards set by a stringent regulatory authority is imperative. This collaboration has the potential to drastically impact access to care and save countless lives."

William G. Cance, MD FACS, Chief Medical and Scientific Officer, American Cancer Society

Sub-Saharan Africa's cancer burden is significant and growing. In 2018, there were an estimated 811,000 new cases of cancer and 534,000 deaths from cancer in the region. Cancer patients in sub-Saharan Africa are twice as likely to die as those in the United States, often due to late diagnosis and lack of access to treatment. Based on population aging alone, annual cancer deaths in sub-Saharan Africa are projected to almost double by 2030. The new agreements reach 23 countries in Africa, covering 74 percent of the annual cancer cases.

The new initiative includes Pfizer, Novartis, and Mylan, and will expand access to the priority medications and formulations in the agreements to additional countries. All of the medications included in the agreements meet the quality standards set by a stringent regulatory authority such as the U.S. Food and Drug Administration (FDA) or the European Medicines Agency (EMA). These medicines will be available for purchase at newly and independently negotiated prices in the designated countries, and the companies have committed to monitoring the impact of their respective agreements with CHAI.

This new Cancer Access Partnership is an initiative of Allied Against Cancer and an expansion of the Chemotherapy Access Partnership. ACS and CHAI began working together in 2015 to improve care and treatment of cancer in sub-Saharan Africa, working with governments and cancer treatment institutions to address market inefficiencies, improve supply chains, and increase procurement to ensure quality medications were available at affordable prices. This collaboration has shown that access to high-quality cancer treatments can be expanded in a sustainable way.

While we have made strides in increasing access to lifesaving cancer treatments in sub-Saharan Africa over the last several years, there is much more work to be done. This collaboration is a significant step in delivering high-quality cancer treatment to more patients, bringing us closer to equitable cancer treatment for all people."

Dr. Iain Barton, Chief Executive Officer of CHAI

In 2017, Allied Against Cancer members ACS and CHAI announced agreements with Pfizer and Cipla to expand access to 16 essential cancer treatment medications in six countries in sub-Saharan Africa. The market access agreements secured competitive prices, allowing these governments to realize substantial savings and improve the quality and quantity of treatment available. As a result of the agreements, several African governments and hospitals increased their commitment to procuring necessary cancer medicines by using the cost savings to increase the volumes of medicines procured, setting up innovative systems to supply high-quality cancer medications, and increasing budgets for cancer care and treatment. Countries that accessed products through the agreements saved an average of 56 percent. As a result, patients have new levels of access to quality chemotherapies in nearly all of the countries included in the original agreements. Three new countries were added in November 2019.

"Since entering into partnership with CHAI and ACS in 2017, we have seen the positive impact that sustainable access to quality, affordable cancer medicines can have on patients in vulnerable communities in Africa," said Rhulani Nhlaniki, Pfizer Cluster Lead for sub-Saharan Africa and Country Manager, South Africa. "We remain committed to this model that helps to reduce the overwhelming burden on patients and healthcare systems, and we are pleased to be able to expand our chemotherapy offerings under the program to better serve the needs of patients."

"Novartis is reimagining medicine and access to healthcare in sub-Saharan Africa with the patient at the center of everything we do," said Racey Muchilwa, Head of Novartis sub-Saharan Africa. "This agreement is an important step to provide lifesaving medicines to more cancer patients across Africa. Having personally seen the growing toll cancer takes on the patients and many affected families in Africa, I am very excited about this collaboration of multiple stakeholders to dramatically improve access to cancer medicines in many countries."

"Mylan is proud to join CHAI, ACS and this important group of industry stakeholders to help expand access to critical medicines for oncology patients. Mylan has a long-standing commitment to support those impacted by non-communicable diseases, including cancer, which significantly impact low- and middle-income countries. We look forward to continuing to do our part by expanding access to treatment through initiatives like the Cancer Access Partnership and working with all involved in the healthcare system to help serve the community," said Rakesh Bamzai, President, India and Emerging Markets, Mylan.

The market access agreements are part of a broader effort to improve access to quality cancer care in Africa. In 2019, ACS, CHAI, the African Cancer Coalition, the National Comprehensive Cancer Network (NCCN), and IBM joined to form Allied Against Cancer. This coalition is leveraging the strengths of each organization to connect with and empower the African oncology community to deliver high-quality cancer care and is working to pursue additional market-based collaborations to increase access to cancer medicines in the region.

NCCN, ACS, and CHAI are also working with the African Cancer Coalition, which comprises 110 leading oncologists from 13 African countries, to adapt the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) to create the NCCN Harmonized Guidelines™ for Sub-Saharan Africa. These NCCN Harmonized Guidelines™ for Sub-Saharan Africa outline pragmatic approaches that provide effective treatment options to improve the quality of care in resource-constrained settings and are available free of charge to health care providers on http://www.nccn.org/harmonized. IBM and ACS also developed ChemoSafe, a suite of training resources for regional healthcare personnel to guide the safe transportation, storage, administration and disposal of hazardous drugs.

The countries included in the agreements are: Botswana, Cameroon, Eswatini, Ethiopia, Ghana, Ivory Coast, Kenya, Lesotho, Liberia, Malawi, Mali, Mozambique, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa, Sudan, Tanzania, Uganda, Zambia, and Zimbabwe, in Africa; and Vietnam, India, and Myanmar in Asia. Oncologists, government officials, and nonprofit organizations in many of these countries contributed to these agreements by sharing information and feedback to the CHAI team.