Annals of Oncology 10:385-390, 1999
© 1999 European Society for Medical Oncology
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Essential drugs for cancer therapy: A World Health Organization consultation
1WHO Cancer Programme, International Agency for Research on Cancer Lyon, France
2Department of Medical Oncology Tata Memorial Hospital, India
3National Cancer Institute Bethesda, MD, USA
4Department of Medicine, University of Zimbabwe Harare, Zimbabwe
5Vrije Universiteit, Department of Medical Oncology Amsterdam, The Netherlands
6Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil
7Department of Cancer Medicine, University of Sydney Australia
8Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences Beijing, China
Correspondence to: WHO Programme on Cancer Control, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
The WHO has previously produced recommendations on the essential drugs required for cancer therapy. Over the last five years several new anti cancer drugs have been aggressively marketed. Most of these are costly and produce only limited benefits. We have divided currently available anti-cancer drugs into three priority groups. Curable cancers and those cancers where the cost-benefit ratio clearly favours drug treatment can be managed appropriately with regimens based on only 17 drugs. All of these are available, at relatively low cost, as generic preparations. The wide availability of these drugs should be the first priority. The second group of drugs may have some advantages in certain clinical situations. Based on current evidence, drugs in the third group are judged as currently not essential for the effective delivery of cancer care. Adequate supportive care programmes with the widespread availability of effective drugs for pain control are of considerably greater importance. The adoption of these priorities will help to optimise the effectiveness and efficiency of chemotherapy and ensure equitable access to essential drugs especially in low resource environments. Clearly this paper represents the views of its contributors. The WHO welcomes feedback from all oncologists so that the advice it gives to governments in prioritising the procurement of anti cancer drugs can be as comprehensive as possible.
chemotherapy, drugs, generics, prioritization
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