{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:45:59Z","timestamp":1792172759890,"version":"4.4.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Renal Cell Carcinoma (RCC) represents a growing global health burden, with rising incidence and mortality worldwide. Despite major therapeutic advances, access to novel systemic treatments remains uneven across countries and regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional, web-based international survey to assess the availability and reimbursement status of 20 innovative systemic therapies for RCC. Responses were collected from 144 clinicians, including medical oncologists, radiation oncologists, urologists, and nuclear medicine specialists, across 58 countries. Analyses examined associations between national income level, gross domestic product (GDP), and treatment availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Thirty-six percent of the countries analyzed had at least 15 of the 20 therapies available. Full reimbursement for at least 15 of the selected innovative therapies was reported in six countries (10%), while 21 countries (36%) fully reimbursed 10-14 therapies and 13 countries (23%) reimbursed 1-9 therapies. In contrast, no full reimbursement for any of the assessed therapies was reported in 18 countries (31%). Higher national income level was significantly associated with greater availability of innovative therapies (Kruskal\u2013Wallis test, P\u2009&amp;lt;\u2009.0001). Armenia (0.709), Greece (0.685), and Israel (0.666) exhibited the highest GDP-adjusted Drug Availability Index (DAI), whereas India (5.195), Nigeria (4.612), and Morocco (3.794) demonstrated the greatest number of available therapies per US$1000 of GDP per capita.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Access to innovative systemic therapies for RCC remains highly unequal at the global level, with reimbursement posing a major barrier even where drugs are available. Internationally coordinated efforts addressing health policy, infrastructure, and equitable pricing are urgently required to ensure that advances in RCC treatment translate into improved outcomes for patients across diverse economic settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag397","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:21:19Z","timestamp":1791199279000},"source":"Crossref","is-referenced-by-count":0,"title":["Global disparities in the availability and reimbursement of systemic therapies for renal cell carcinoma: results of the International ARON-AID Survey"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9152-9887","authenticated-orcid":false,"given":"Yuksel","family":"Urun","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Ankara University Faculty of Medicine , Ankara 06620, T\u00fcrkiye"},{"name":"Cancer Research Institute, Ankara University , Ankara,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannan","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, Arabian Gulf University , Kingdom of","place":["Bahrain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-5762","authenticated-orcid":false,"given":"Anca","family":"Zgura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics-Radiotherapy, Alexandru Trestioreanu Institute of Oncology, \u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Zayed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center , Amman,","place":["Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Ignacio Zapata","family":"Laguado","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Instituto Nacional de Cancerolog\u00eda , Bogot\u00e1,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4622-4742","authenticated-orcid":false,"given":"Tarkan","family":"Yetisyigit","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bahrain Oncology Center , Muharraq,","place":["Bahrain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Urology, Saitama Medical Center, Saitama Medical University , Kawagoe, Saitama,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4338-0889","authenticated-orcid":false,"given":"Mike","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Frankfurt, Goethe University , Frankfurt, Frankfurt am Main,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno","family":"Vau","sequence":"additional","affiliation":[{"name":"Urologic Oncology, Champalimaud Clinical Center , Lisbon 1400-038,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Tural","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ko\u00e7 University School of Medicine , Istanbul,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4947-0304","authenticated-orcid":false,"given":"Karine","family":"Trindade","sequence":"additional","affiliation":[{"name":"Oncocentro Cear\u00e1 (Rede D\u2019Or) , Fortaleza,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Peter MacCallum Cancer Centre , Melbourne,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9161-4918","authenticated-orcid":false,"given":"Frederic Ivan Leong","family":"Ting","sequence":"additional","affiliation":[{"name":"Section of Medical Oncology, Department of Internal Medicine, Corazon Locsin Montelibano Memorial Regional Hospital , Bacolod 6100,","place":["Philippines"]},{"name":"Department of Clinical Sciences, College of Medicine, 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