Examininig The Extent of Application of Cost-Minimization Analysis and Its Assocaition With the Availability of Anticancer Medications: An applied study in The Oncology Hospital/ Medical City Complex-Baghdad, Iraq.


Background: The availability of chronic diseases medications is an essential component of any welfare healthcare system. As a result of the inflated demand for these drugs, and the substantial cost they incur, several managerial approaches have been used to ensure the optimum use of the usually scarce financial healthcare resources. Cost-Minimization Analysis is an approach of pharmacoeconomics that deals with the use of generic medications wherever the legal and bioequivalence conditions are available. Objective: to determine whether the usually scarce financial resources are used in an optimum manner, through examining the level of application of Cost-Minimization Analysis (CMA) approach, as a mean of evaluating different bioequivalent alternatives, in order to incur maximum cost saving in the process of product procurement. Methods: This is an observational, cross-sectional study through reviewing the manufacturing sources, originator or generic, of the available anticancer medications in the surveyed oncology hospital, and how that affects the availability of these medications at the moment of conducting the study. Results: Out of 71 drugs in the Iraqi National Anticancer Drugs List, only 21 drugs (29.58%) were available. Twelve drugs out of the available twenty one medicines are originators (57.12%), seven medicines are generics (33.33%) and two drugs are available in both generic and originator form (9.53%). Out of the twelve products available from the original sources, only Rituximab is an available originator where no bioequivalent alternative generic is legally available (8.33%), while bioequivalent alternative generics are internationally available for the other eleven drugs (91.67%). Conclusions: there is a clear shortage of anticancer drugs in the surveyed oncology hospital. The Iraqi public healthcare sector is struggling to meet the actual needs of the medications listed in the national drug list, although the list does not contain unproven cost-effective anticancer medicines. The study demonstrated potential mismanagement of the scarce financial resources in the scope of non-application of Cost-Minimization Analysis; significant financial resources are devoted to originator- source medicines, the alternative bioequivalent generics of which are available.