Availability, Affordability, and Pricing of Anti-cancer Medicines in Selected Low and Middle-Income Countries in Africa

  • Phyllis Ocran

Student thesis: Doctoral Thesis


Introduction: Cancer is a leading cause of morbidity and mortality in Low-and Middle-Income Countries (LMICs). Health outcomes may improve with early detection and treatment. In several African countries including Ghana and South Africa, due to the absence of a clear medicine pricing policy, cancer medicines have high price variations due to forex fluctuations, and import tariffs, which impact access.

Aim: This research aimed to assess the availability, affordability, prices, and price components of cancer medicines in South Africa and Ghana.

Method: A systematic literature review was undertaken on the availability, pricing, affordability, and access to cancer medicines in LMICs. An adapted World Health Organization (WHO) and Health Action International (HAI) methodology was used to determine the availability, prices, and affordability of cancer medicines in South Africa and Ghana, including a case study to assess the price components in the Ghana distribution chain. Also, affordability according to the impoverishment of the population after procuring cancer medicines in South Africa was determined.

Results: The literature review showed that in LMICs, there are wide differences in cancer medicine availability and prices amongst medicine brands in different countries, with low-income earners abandoning treatment because of unaffordability. This research showed similar findings of very low availability of cancer medicines beneath the WHO target of 80%, substantial differences in the prices of different cancer medicine brands due to high markups for both generics and branded medicines in all sectors, originator brands having higher markups than generic products, high medicine prices in private facilities compared to the public facilities and unaffordability of cancer medicines by low-income earners with some impoverished after buying cancer medicines.

Conclusion: This research contributes to academic knowledge and the findings can support quality pricing data, comprehensive policies, regulations, and innovative interventions by governments and stakeholders to improve affordable access to cancer medicines.
Date of Award12 Oct 2023
Original languageEnglish
SupervisorZaheer Babar (Main Supervisor) & Shahzad Hasan (Co-Supervisor)

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