Background: Cancer drugs challenge health-care systems because of their high prices. Drugs prices, health-care systems and GDP are no uniform throughout the world. United Kingdom (UK) has a 320% better GDP than Argentina (ARG). Aim: We aimed to compare the prices of cancer drugs in both countries, including originals, generics/copies and biosimilars available in ARG by July 2017. Methods: We surveyed official list prices per unit at ex-factory price level of 52 original cancer drugs in UK and ARG. Drugs were grouped in low (LPD) (10), medium (MPD) (7) and high prices (HPD) (35). We included prices of generics/copies (74 generics brands of 7 LPD and 46 generics brands of 6 MPD and HPD) and biosimilars (2) available in ARG and compared with those from originals. Surveyed prices did not include negotiated discounts as authorities and third payers use these undiscounted official lists to set health care. We calculated appropriate discounts to equate prices. Results: In ARG the difference of a drug price between generics/copies and originals has an average of 10.6% less for nonoriginals (range +5% to −24%). No nonoriginals drugs cost less than 24% of originals. Great variations of prices (57%) among generics. The difference of price between biosimilars and originals was 13.8% less for biosimilars. The differences of a drug price between UK and ARG showed that: a) LPD prices in ARG were 53% (−39% to +68%) more expensive than in UK, b) 86% of MPD are more expensive in ARG than in UK, with an average of 222% (−49% to +707%), c) 100% of HPD are more expensive in ARG than in UK, with an average of 123% (+8% to +408%). When translating to currency (all in US$) differences were an average of: a) LPD +141 (−353 to +412), b) MPD +1295 (−164 to +2531), and c) HPD +2649 (+471 to +10,359) more expensive in ARG than in UK per unit. Average discounts necessary to equate undiscounted official ARG list to undiscounted official UK list are: LPD 45% (24-64), MPD 71% (60-87), HPD 51% (13-80). Conclusion: a) Our results show great variations in prices between both countries. b) Prices are inversely related to GDP. c) 100% of HPD and 86% of MPD have overprices in ARG respect to UK with an average of 123% and 222% respectively. d) In currency these represent an average overpayment of US$ 2649 and US$ 1295 per unit respectively. e) Appropriate discounts to equate ARG list to UK list should be around 50%–70%. f) In ARG, differences of prices between generics/copies/biosimilars and originals are less than 24%, with an average of 10%–13%. g) By using undiscounted lists there is a high risk of overpayment. Unpublished final prices list may preclude a good decision making process even at physician level, considering that many of MPD and HPD are directed to stage IV noncurative patients with marginal quality of life advantages for some of these treatments. h) Our findings provide an evidence base for policy makers in nonhigh income countries.
Long-term hospital attendance of children and adults who have undergone removal of normal or inflamed appendices
