OnCo
ideasIdea

Pooled procurement and voluntary licensing for essential cancer medicines in low-income countries

Buy essential cancer drugs for many countries at once and license newer ones to generic makers, as was done for HIV, so prices fall to what those health systems can pay.

HIV treatment reached tens of millions because the Medicines Patent Pool, pooled procurement and tiered pricing lowered costs by over 90%. Cancer has partial efforts (the ATOM Coalition, pooled tenders for childhood cancer drugs) but no comprehensive mechanism. The proposal is a cancer medicines pool: voluntary licences from originators for defined territories on a core list (trastuzumab, imatinib, pembrolizumab or biosimilar checkpoint inhibitors, and generics with supply problems), pooled multi-country tenders, quality assurance and supply security, financed with development bank guarantees.

Hypothesis
Pooled licensing and procurement cut prices of listed medicines by over 70% in participating countries and increase the treated fraction of eligible patients severalfold within five years.
Rationale
Volume, predictability and competition among licensed manufacturers are what drove HIV prices down; the same levers are available for cancer biologics and small molecules.
What would test it
Pilot pooled procurement of five essential medicines across ten countries; measure price, availability and treatment rates against baseline.
Maturity
early clinical
Who has to act
policy
Cost to try
Large (over $50M)
Years to first evidence
4
Bottlenecks it attacks
  • 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.

Connected

5top