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How pharmaceuticals offer cheaper cancer drugs

But for people like Bradford, the secret is in the number of potential customers. When asked why they picked interest in the deal, he said over 40% of Ugandans will undergo a cancer diagnosis during their lifetime. He, however, maintained that Cipla will charge just enough to cover its manufacturing and packaging costs.

“Our aim is to increase access to quality medicines,” he said.

When the same question was put to Novartis’ Dr. Nathan Mulure, he put it more bluntly.

“We might see the demand for these drugs increasing in Africa with NCDs being on an increase,” he said, “With our approach of Novartis Access we are targeting numbers. The idea is to provide cheap drugs for many people.

“That’s why you find we are supplying a drug at one dollar whereas on a market it costs up to 100 and 140 dollars”. In the five years duration of the Memorandum of Understanding, Mulure is positive that they should have made money out of the deal.

Mwesige also speaks of the economies of scale. According to him, many companies are testing new pricing models with growth in spending on drugs. His argument fits into predictions as far back as 2014 by IMS institute for HealthCare informatics that spending on drugs in emerging markets like Uganda would grow by 10 to 13% by 2018.

“They are interested in emerging countries so they can make money,” Mwesige says.

Mwesige, however, has reservations on the proposed model.

“I don’t know how feasible it is,” he says, “There are only 16 items which is a very small range of the medicines.” To ensure impact of drugs, he says, doctors often use a combination to treat patients and that the modality of cancer treatment is that there’s no single drug that will provide effectiveness.

He says the kind of drugs to give a patient depends on what one intends to achieve – whether it’s to cure, to prevent symptoms, or to palliate. He adds that the drugs administered depend on one’s age. He says offering discounts for specific drugs and not others is one of the reasons the National Medical Stores, the government’s drugs procuring entity, often faces challenges with cancer drugs.

For the same reasons he says, cancer has not received as much funding from donors as HIV yet cancer is dynamic – “today one is treating cancer of the stomach, tomorrow it will be cancer of the colon for the same individual.”

O’Brien is, however, positive that drug price cuts can grow cancer treatment programs effectively. She says this initiative is modeled on the campaign used earlier to improve access to HIV medicines in Africa where drug companies initially cut their prices before donors eventually came on board.

The drugs to be supplied:

Pfizer

– Carboplatin , Cisplatin, Docetaxel, Doxorubicin, Epirubicin, Fluorouracil, Gemcitabine, Leucovorin, Methotrexate, Oxaliplatin and Paclitaxel

Cipla

– Anastrozole, Bleomycin, Capecitabine, Carboplatin, Cisplatin, Cytarabine, Oxaliplatin and Vinblastine

Novartis – all for breast cancer

– Anastrozole, Letrozole and Tamoxifen

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