Public-option manufacturing for essential generic cancer drugs in shortage
Cheap, essential chemotherapy drugs such as cisplatin keep running short because there is little profit in making them. A publicly-backed non-profit manufacturer would guarantee supply at a fair price.
Extend the Civica Rx and California CalRx model to a portfolio of essential oncology generics that repeatedly fall into shortage (cisplatin, carboplatin, methotrexate, fluorouracil, vincristine, etoposide, BCG): a non-profit manufacturer or contracted network with public capital, long-term purchase agreements from hospital systems and national payers, redundant production sites, and transparent cost-plus pricing. Where the public option also supplies low- and middle-income countries through pooled procurement, it addresses global access at the same time. The problem is not scientific; it is a market that rewards exit from low-margin sterile injectables.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
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