The cost of cancer medicines has changed significantly over time, influenced by factors such as competition, exchange rates, regulatory policy, and introduction of generic alternatives.
This has yielded massive price variations that are proving a challenge to both patients and medical personnel.
David Wata, an oncology pharmacist at Kenyatta National Referral Hospital (KNH), says while some drugs have become more affordable due to increased competition, others remain expensive due to patents, making access to treatment a challenge for many patients.
"Competition plays a crucial role in determining drug prices. When a new cancer drug is introduced by a single manufacturer, its cost is typically high due to research and development costs. However, when several companies start producing the same drug or alternative treatments, competition can drive prices down. A drug introduced by one manufacturer a decade ago may now be available from several manufacturers, leading to lower costs. On the other hand, new and more advanced treatments often remain expensive due to limited availability and patent protection," said Dr Wata.
There are three main types of cancer treatment, including conventional chemotherapy, targeted therapy, and immunotherapy.
Conventional chemotherapy uses drugs to kill rapidly dividing cancer cells, but it can also affect healthy, fast-growing cells. Common chemotherapy drugs such as vincristine (Sh300 per vial), cyclophosphamide (Sh350 per vial), cisplatin (Sh700), doxorubicin (Sh900), and cytarabine (Sh400) have remained relatively stable in price over the past five years.
Most of these drugs are supplied by Indian manufacturers, and price fluctuations are mainly due to changes in manufacturers' and distributors' profit margins.
"Traditional chemotherapy drugs have remained relatively stable in price because they have been on the market for a long time and manufacturers have streamlined their production. However, even small fluctuations in distributors' profit margins or changes in suppliers can affect affordability for patients".
He added: "These drugs, although stable in price, still represent a financial burden for many families, especially when treatment involves multiple cycles over months or years.
Targeted therapies, which attack specific molecules involved in cancer growth, include drugs such as rituximab (Sh70,000 per 500mg), trastuzumab (Sh35,000 per 600mg) and bevacizumab (Sh70,000 per 400mg). European brands of these drugs have dropped in price, while Indian alternatives have remained stable.
"Competition from Indian manufacturers has made targeted therapies more affordable for some patients, although they remain expensive compared to chemotherapy," noted Dr Wata.
Catherine Mueni, a consultant medical oncologist, added that the cost of targeted therapies can range from around Sh25,000 per month for generic versions to over Sh500,000 for original brands.
She said that while the Social Health Authority (SHA) provides some support, it does not cover the full cost of advanced treatments.
"This gap forces many patients to rely on personal savings or fundraising efforts to afford the drugs they need," said Dr Mueni.
In addition, supply chain disruptions contribute to the volatility of drug prices. Dr Mueni noted that delays in procurement and distribution inefficiencies can lead to shortages of essential cancer medicines, resulting in price increases due to increased demand and limited supply.
Immunotherapy, a newer and more advanced treatment, boosts the body's immune response against cancer. However, these drugs are still among the most expensive. Pembrolizumab was initially priced at Sh270,000, while nivolumab cost Sh450,000 when only the European brand was available.
"The introduction of a cheaper Indian version of nivolumab forced the European version out of the market as it could not compete. Similarly, atezolizumab was introduced at Sh270,000 and has remained expensive due to limited manufacturers. Immunotherapy is a game changer in cancer treatment, but its cost remains unaffordable for many patients. These drugs are not as widely available as chemotherapy and their use is often limited to specific cases due to their high price," said Dr Wata.
Dr Wata also noted that exchange rates have a major impact on the price of these drugs. As many of these drugs are imported, a weakened local currency leads to higher costs for importers.
"Exchange rate fluctuations have played a significant role in the rising cost of some cancer drugs. A depreciating shilling results in higher import costs, which are then passed on to patients," he said.
In addition, regulatory policies and access programmes also have an impact on drug prices. Government regulations, tax policies, and international pharmaceutical agreements can either increase or decrease costs.
Kenya faces a growing cancer burden, with approximately 47,000 new cases and 32,000 deaths each year, according to the Kenya National Cancer Registry. The most common cancers are breast, cervical, prostate, oesophageal, and colorectal.
Although there has been a slight reduction in drug prices in public hospitals, private hospitals, especially top ones, continue to charge higher prices.
"Affordability remains a key issue," said Dr Wata. "Even with price reductions, many patients struggle to access life-saving medicines due to financial constraints. Overall, while cancer drug prices have decreased slightly, especially in public hospitals, larger private hospitals have seen fewer price reductions, making some treatments unaffordable for many patients."
In response to these persistent problems, the government has increased the oncology care package, under SHA from Sh400,000 to Sh550,000 per household per year. However, this amount is still relatively low considering the frequency of hospital visits and the cost of drugs.
