Availability and affordability of anticancer medicines: a case study at ocean road cancer institute in Dar es salaam, Tanzania

Abstract

Background: In Tanzania and other East African countries little is documented regarding the availability and affordability of anticancer medicines at the patient level. Also it is not known if anticancer medicines prescribed at the Ocean Road Cancer Institute (ORCI) are available for the patients. The number of anticancer medicines prescribed to the cancer patients is also not known. It is also not known if there were other financing mechanisms for anticancer medicines to the patients treated at chemotherapy department. Objective: To determine and assess the availability of anticancer medicines to patients attending chemotherapy clinic at ORCI in Dar es salaam. Also to find out the prices of anticancer medicines in private pharmacies which are accessible by patients treated at ORC!. Alternative sources of funds to the ORCI in Dar es Salaam were also reflected in the process of the study. Methodology: A cross-sectional study was carried out to patients attending the ORCI chemotherapy clinic between March and May 2010. A total of384 cancer patients aged 18 and above and on chemotherapy treatment were included in the study. Some health care providers at the chemotherapy department and dispensing personnel in the private pharmacies were interviewed for availability and accessibility of anticancer medicines. Results: The mean anticancer medicines prescribed were 2.01 with the mean anticancer cost reported by patients to be TSh 106,300. The availability of medicines at the ORCI for the management of cancer patients was about 50% of all surveyed medicines. In private pharmacies the unit cost for medicines was very high ranging from TSh 2,500 to 744,000 which were equivalent from one day income of the respondents to seven month income. The average amount of money the patients paid to buy anticancer medicines was TSh 151,100 for one course of treatment. More than 90% of the medicines surveyed at both ORCI and private 'pharmacies accessible by ORCI cancer patients were generics. Conclusion Availability of anticancer medicines at ORCI in Dar es Salaam is not adequate. As a result, patients are required to buy anticancer medicines from private pharmacies in Dar es Salaam. In these private pharmacies anticancer medicines are too costly and most patients are not covered by health insurance to purchase their medicines.

xv Efforts should be made to Increase budgetary allocation for purchase of anticancer medicines at ORC!.