“Dying to Survive” is a 2018 Chinese comedy-drama film based on a real-life story of Yong Lu, a Leukemia patient who imported generic cancer drugs from India to China to supply fellow patients suffering from Chronic Myeloid Leukemia (CML) who could not afford the cost of the domestically available medication. When Yong was arrested in 2013, the charge against Yong was eventually dropped following a public outcry by over 1,000 patients whose lives had been extended by his efforts. This case and the film have sparked public debate about high medical costs, were credited with prompting government steps to make cancer medicines more accessible and affordable.
Seven years ago (2011), I heard about an individual patient trying to get a generic cancer drug from India and looked into the cancer drug prices. I found that the price was higher in China than in UK. The main reason I thought was those foreign drugs were not covered in Chinese National Health Insurance, i.e. no patients access scheme. I am glad seeing that some cancer drugs have lowered prices via national health insurance since 2017.
I thought UK patients were lucky with NHS (National Health Service) in the way that we didn’t need to worry about high medical costs. But days after the film “Dying to Survive”, I heard from one metastatic cancer patient that she needs to pay for five thousand pounds per month for one drug which is not covered by NHS! Isn’t’ the sky-high cost described in the film “Drying to Survive”? Based on the Office for National Statistics’ (ONS’s) Living Costs and Food Survey, the UK median disposable household income was £27,300 in the financial year of 2017. How many families can afford this type of cancer drugs?
I looked into the application submitted to NICE (National Institute for Health and Care Excellence) by the pharmaceutical company in 2010. The proposed price (for patient access scheme) for the above drug was 1600 pounds per month (20800 pounds per year), and free after one year of treatment. So it is clear that if the cancer drugs were sold to an individual, wherever you are in developing country (e.g. China) or in a developed country (e.g. UK), the cost was much higher than that to the government.
Is there anything can be done to make more cancer drugs accessible and affordable? I understand that NHS is not able to cover all drugs. Would NICE consider partial payment for certain drugs, not just black (0% cover) or white (100% cover)? Take the above 5000 pounds’ drug as example, if NHS still secures the patient access scheme’s price (1600 pounds per month) and pay 50% (or even 30%) of the drug, individual patient only need to pay 800 (or 1120) pounds per month, much lower than 5000 pounds per month! And those patients who survived after one year don’t need to worry about how they can afford to extend their lives.
In addition to the support from NHS, I think individuals should consider buying private insurance, either private medical insurance or critical illness insurance. If you are unlucky and need sky-high cost of cancer drugs (or other treatment), the insurance company will pay for the full or partial cost; if you are lucky, the money you pay to the insurance company will help other patients.
Last but not least, pharmaceutical companies need to work more to reduce the cost of drug development. As an employee of a world-leading cancer drug development company, I know we are trying hard in “doing now what patients need next”. But imagine you could be a cancer patient in future, can you afford the drugs you developed by yourself?
PS: In 2009, I was diagnosed with breast cancer and luckily have survived for 9 years till now. I wrote my first cancer-related blog post on 26th August 2009 and have been blogging since then. So this post is a celebrating of my survival, also a hope for more cancer patients’ longer survival.