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Cancer survival statistics should be viewed with caution.pdf
Re?ection and Reaction
?gure should be kept in mind by health-care authorities, especially in the developing world, when compiling their list of disease priorities.
Another aspect to be considered is the price of cancer drugs. The formula by which pharmaceutical industries calculate the costs of drugs is not transparent. With the introduction of generic medications in Brazil, the price of certain anticancer drugs has been reduced by almost 90%. This discrepancy in the pricing of identical trade and generic drugs suggests that manufacturers are setting prices in a way that allows a large pro?t margin to recoup their expenses handsomely. For example, in Brazil, the average cost of one milligram of pegylated interferon is about US$2·60 compared with one milligram of gold that was recently trading at about US$0·026!
A further important point is that nowadays, patients and their relatives have considerable access to medical information. Although such access has obvious advantages, it has also added a new and unpredictable component to government health-care budgets. Because cancer is universally seen as a fatal disease, legal demands from patients often force health ministries to purchase new, supposedly e?cacious, drugs even when their cost–bene?t is not yet known.
Since 2005, about 10 000 legal demands for purchasing new drugs have been successful in southern Brazil. In general, judges are being misled into making decisions on the basis of medical recommendations that have not been based on published consensus papers, ?ndings of meta-analyses, or therapeutic guidelines produced by WHO or other international medical organisations.
Wewill certainlyusethe information provided by Rawlins to guide our health-care authorities in dealing with these important issues. In Brazil, the average per-capita annual gross domestic product is slightly over US$4000 and few, if any, of the new cancer drugs would fall within the WHO cost-e?ectiveness bracket in our country.4
*Gilberto Schw
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