{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:20:04Z","timestamp":1779294004938,"version":"3.51.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate anticancer medicines\u2019 availability, price and affordability in nine prefecture-level cities, Jiangsu Province.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on the standard methods recommended by the World Health Organization (WHO) and the Health Action International (HAI), a cross-sectional survey was performed to collect information about 24 essential anticancer medicines (EAMs) and 17 innovative anticancer medicines (IAMs) in hospitals and 45 community pharmacies in Jiangsu Province from July to November 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In general, the availability of EAMs during the study period was higher than that of IAMs, and the availability of the Lowest-priced generics (LPGs) was higher than that of the originator brands (OBs). Anticancer medicines in hospitals were more available than those in community pharmacies. Specifically, the availability of anticancer medicines positively correlated with different cities\u2019 economic status. However, there were no significant changes in the availability of IAMs among different cities. The median price ratio (MPR) value of OBs was greater than that of LPGs, and both were greater than one. There were no significant changes in the MPR value of EAMs among different economic regions (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). The price of IAMs was significantly greater than the median price of 18 European countries. There were significant changes in the affordability of EAMs and IAMs among different cities (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). In this research context, IAMs had poor affordability, but LPGs had good affordability for the residents. The affordability of urban residents was better than that of rural residents.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The availability of anticancer medicines in community pharmacies was low, especially in intravenous anticancer preparations. The Chinese government formulated a dual-channel policy to improve the availability of anticancer medicines in community pharmacies. However, implementing the dual-channel policy required the effective interaction and cooperation of the hospitals, community pharmacies, medical insurance, and other departments. The price of IAMs was still the main obstacle to receiving treatment for cancer patients; therefore, the government should further optimize the price of IAMs through various strategies to achieve a reasonable price. Expanding the coverage of EAMs was conducive to improving treatment affordability for cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1729325","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T06:41:43Z","timestamp":1766040103000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Availability, price and affordability of anticancer medicines in Jiangsu Province, China: a cross-sectional survey study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanping","family":"Yao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuying","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haomin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanhui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoliu","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiantian","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3029","DOI":"10.1002\/cncr.33587","article-title":"The ever-increasing importance of cancer as a leading cause of premature death worldwide","volume":"127","author":"Bray","year":"2021","journal-title":"Cancer"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2050312117738691","DOI":"10.1177\/2050312117738691","article-title":"Survey on the availability, price and affordability of selected essential medicines for non-communicable diseases in community pharmacies of Kathmandu valley","volume":"5","author":"Shrestha","year":"2017","journal-title":"SAGE Open Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"623-A","DOI":"10.2471\/BLT.13.128348","article-title":"Rallying United Nations organizations in the fight against non-communicable diseases","volume":"91","author":"Chestnov","year":"2013","journal-title":"Bull World Health Organ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1186\/s12913-020-05167-9","article-title":"Availability, prices, and affordability of selected essential cancer medicines in a middle-income country\u2013the case of Mexico","volume":"20","author":"Moye-Holz","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12885-017-3980-3","article-title":"Availability of anticancer medicines in public and private sectors, and their affordability by low, middle and high-income class patients in Pakistan","volume":"18","author":"Sarwar","year":"2018","journal-title":"BMC Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"734637","DOI":"10.3389\/fphar.2021.734637","article-title":"What factors hindered the access to essential anticancer medicine in public hospitals for the local population in Hubei Province, China","volume":"12","author":"Chen","year":"2021","journal-title":"Front Pharmacol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3728","DOI":"10.3390\/ijerph16193728","article-title":"Availability, price and affordability of anticancer medicines: evidence from two cross-sectional surveys in the Jiangsu Province, China","volume":"16","author":"Zhu","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"ref8","year":"2025"},{"key":"ref9","year":"2021"},{"key":"ref10","year":"2020"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/S1470-2045(15)00449-0","article-title":"Cancer drugs in 16 European countries, Australia, and New Zealand: a cross-country price comparison study","volume":"17","author":"Vogler","year":"2016","journal-title":"Lancet Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12939-018-0870-5","article-title":"A survey of availability, price and affordability of essential medicines from 2011 to 2016 in Chinese secondary and tertiary hospitals","volume":"17","author":"Guan","year":"201","journal-title":"Int J Equity Health"},{"key":"ref13","first-page":"510","article-title":"Investigation on the accessibility of emergency drugs in medical institutions in Nanjing","volume":"20","author":"Fang","year":"2020","journal-title":"J Nanjing Med Univ"},{"key":"ref14","volume-title":"Distribution of health payments and catastrophic expenditures methodology","author":"Xu","year":"2005"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1016\/S1470-2045(21)00463-0","article-title":"Access to cancer medicines deemed essential by oncologists in 82 countries: an international, cross-sectional survey","volume":"22","author":"Fundytus","year":"2021","journal-title":"Lancet Oncol"},{"key":"ref16","first-page":"209","article-title":"Association between regional economic development and cancer incidence and mortality in China","volume":"27","author":"Cao","year":"2023","journal-title":"Zhonghua Dis Control J"},{"key":"ref17","year":""},{"key":"ref18","year":""},{"key":"ref19","year":""},{"key":"ref20","first-page":"734","article-title":"Research on the infusion management model of national reimbursement negotiation drugs under \u201cdual channel\u201d management mechanism","volume":"42","author":"Li","year":"2021","journal-title":"World Clin Drugs"},{"key":"ref21","first-page":"229","article-title":"Overview and analysis of drugs for national medical insurance negotiations over the years -- special topic of antitumor drugs","volume":"11","author":"Li","year":"2021","journal-title":"Oncologia"},{"key":"ref22","first-page":"16","article-title":"Study on the accessibility of drugs for national negotiation access","volume":"1","author":"Liu","year":"2023","journal-title":"China Med Insur"},{"key":"ref23","volume-title":"Research on public security policy and drug accessibility evaluation of new antitumor drugs in China [D]","author":"Diao","year":"2020"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"725","DOI":"10.13683\/j.wph.2021.09.003","article-title":"Research on DTP pharmacy management under \"dual channel\" management mechanism","volume":"42","author":"Chen","year":"2021","journal-title":"World Clin Drugs"},{"key":"ref25","year":""},{"key":"ref26","year":""},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/JTO.0000000000000257","article-title":"Safety and effectiveness of bevacizumab-containing treatment for non\u2013small-cell lung cancer: final results of the ARIES observational cohort study","volume":"9","author":"Lynch","year":"2014","journal-title":"J Thorac Oncol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1016\/S0140-6736(16)31388-5","article-title":"Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial","volume":"388","author":"Zhang","year":"2016","journal-title":"Lancet"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1002\/onco.13853","article-title":"Phase II study of 5-fluorouracil, oxaliplatin plus dasatinib (FOLFOX-D) in first-line metastatic pancreatic adenocarcinoma","volume":"26","author":"George","year":"2021","journal-title":"Oncologist"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"020603","DOI":"10.7189\/jogh.09.020603","article-title":"How government insurance coverage changed the utilization and affordability of expensive targeted anti-cancer medicines in China: an interrupted time-series study","volume":"9","author":"Diao","year":"2019","journal-title":"J Glob Health"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/S1470-2045(20)30702-6","article-title":"Pyrotinib plus capecitabine versus lapatinib plus capecitabine for the treatment of HER2-positive metastatic breast cancer (PHOEBE): a multicentre, open-label, randomised, controlled, phase 3 trial","volume":"22","author":"Xu","year":"2021","journal-title":"Lancet Oncol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1001\/jamaoncol.2021.6268","article-title":"Apatinib vs placebo in patients with locally advanced or metastatic, radioactive iodine\u2013refractory differentiated thyroid cancer: the REALITY randomized clinical trial","volume":"8","author":"Lin","year":"2022","journal-title":"JAMA Oncol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1056\/NEJMoa1214886","article-title":"Crizotinib versus chemotherapy in advanced ALK-positive lung cancer","volume":"368","author":"Shaw","year":"2013","journal-title":"N Engl J Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.1056\/NEJMoa0912614","article-title":"Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia","volume":"362","author":"Saglio","year":"2010","journal-title":"N Engl J Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/S0140-6736(06)69446-4","article-title":"Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial","volume":"368","author":"Demetri","year":"2006","journal-title":"Lancet"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.lungcan.2019.05.008","article-title":"Combination of icotinib and chemotherapy as first-line treatment for advanced lung adenocarcinoma in patients with sensitive EGFR mutations: a randomized controlled study","volume":"133","author":"Xu","year":"2019","journal-title":"Lung Cancer"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/S1470-2045(11)70393-X","article-title":"Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial","volume":"13","author":"Rosell","year":"2012","journal-title":"Lancet Oncol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/s1470-2045(13)70093-7","article-title":"Axitinib versus sorafenib as second line treatment for advanced renal cell carcinoma: overall survival analysis and updated results from a randomized phase 3 trial","volume":"14","author":"Motzer","year":"2013","journal-title":"Lancet Oncol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2946","DOI":"10.1200\/JCO.2011.39.6820","article-title":"Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65\/GMMG-HD4 trial","volume":"30","author":"Sonneveld","year":"2012","journal-title":"J Clin Oncol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"4256","DOI":"10.1002\/cncr.25219","article-title":"Phase 3 trial of everolimus for metastatic renal cell carcinoma: final results and analysis of prognostic factors","volume":"116","author":"Motzer","year":"2010","journal-title":"Cancer"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"835103","DOI":"10.3389\/fimmu.2022.835103","article-title":"Comparison of chemotherapy combined with chidamide versus chemotherapy in the frontline treatment for peripheral T-cell lymphoma","volume":"13","author":"Wang","year":"2022","journal-title":"Front Immunol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"4416","DOI":"10.21037\/jtd-22-1292","article-title":"Extended use of rh-endostatin improves prognosis in patients with advanced non-small cell lung cancer: an analysis of retrospective study","volume":"14","author":"Zhao","year":"2022","journal-title":"J Thorac Dis"},{"key":"ref43","first-page":"2212","article-title":"Study on evaluation method for the accessibility of essential medicine in China based on WHO\/HAI standardized approach","volume":"24","author":"Shi","year":"2013","journal-title":"China Pharm"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1729325\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T06:41:48Z","timestamp":1766040108000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1729325\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":43,"alternative-id":["10.3389\/fpubh.2025.1729325"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1729325","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"article-number":"1729325"}}