Availability and affordability of anticancer medicines at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania

Abstract

Background: To ensure effective control of cancer, patients undergoing chemotherapy should get continuous supply of anticancer medicines. In Tanzania and other East African countries little is documented regarding the availability and affordability of anticancer medicines at the patient level. The number of anticancer medicines prescribed to the cancer patients and its cost implication is also not known.

Objective: To determine the availability of anticancer medicines to patients attending chemotherapy clinic at Ocean Road Cancer Institute (ORCI) in Dar es salaam, Tanzania. Also to find out the prices of anticancer medicines in private pharmacies and affordability by cancer patients treated at ORCI.

Methodology: A cross-sectional study was carried out between February and May 2010 in patients receiving cancer chemotherapy at ORCI. A total of 384 adult cancer patients registered for chemotherapy were included in the study. Patients, health care providers at the chemotherapy department and dispensing personnel in the private pharmacies were interviewed regarding availability, accessibility and affordability of anticancer medicines.

Results: The mean anticancer medicines prescribed per patient was 2.01, with the mean cost for anticancer drugs reported by patients to be 106,300 shillings. The availability of medicines at the ORCI for the management of cancer patients was about 50% of all surveyed medicines. As a result more than 70% of patients did not get the prescribed anticancer medicines at the hospital. In the private pharmacies, the unit cost for anticancer medicines was very high, ranging from 2,500 to 744,000 shillings, which is equivalent
to 1-7 months income of the patient.

Conclusion: Availability of anticancer medicines at ORCI in Dar es Salaam is not adequate. As a result, some patients are required to buy anticancer medicines from private pharmacies . In these private pharmacies  anticancer medicines are too costly and most patients are not covered by health insurance to purchase their medicines. Efforts should be made to increase budgetary allocation to ensure adequate and uninterrupted supply of anticancer medicines to cancer patients at ORCI.