By Mouadh Tabainat — Président de l’ANPHA · pharmaccess.dz mai 2024
A major public health challenge
The National Association of Algerian Pharmacists (ANPHA), established in
2020, brings together pharmacists from different sectors to address the
scientific and socio-economic issues surrounding medicines. Its aim is
to keep pharmacists at the heart of discussions on healthcare products,
in the service of patients, clinicians, researchers and decision-makers.
On 18 November 2023, at ESHRA in Algiers, ANPHA held its sixth summit,
focusing on cancer and the roles of community and hospital pharmacists.
The meeting brought together clinicians, pharmacists, public
authorities, economic stakeholders and representatives of the central
purchasing body around one key question: how can cancer-control plans
and cancer therapies be funded sustainably in Algeria?
Rising incidence and evolving treatments
Estimates cited during the discussions indicated approximately 58,000
new cancer cases in 2022, with a projection of 62,000 cases in 2025. The
number of deaths associated with the disease was estimated at 32,000. In
2020, the median age at diagnosis was 50. These trends highlight the
importance of strengthening prevention, screening and treatment
capacity.
Haematological cancers were reported to account for 11% of cancers in
Algeria and to be the leading cancer category among children. Their
diagnosis and treatment are complex and may require specialist teams and
protected, or even sterile, units.
Population ageing and improved detection capacity are contributing to
growing needs. Chemotherapy, radiotherapy and surgery remain pillars of
treatment, alongside targeted therapies and immunotherapies. These
innovations can improve care, but they also make questions of access,
planning and funding increasingly pressing.
Securing sustainable funding
In Algeria, the state funds most services and treatments delivered in
public healthcare facilities. However, some laboratory and radiology
tests prescribed by public institutions are carried out in the private
sector, requiring coordination among the different stakeholders.
Figures presented for 2022 estimated that cancer-related expenditure
represented approximately 10--15% of the healthcare budget. In 2023,
operating funds allocated to operational cancer centres amounted to 12
billion dinars. Investment appropriations allocated to cancer centres
for the 2021, 2022 and 2023 financial years totalled 17.9 billion
dinars.
Beyond the amounts committed, the challenge is to ensure continuity of
care and give stakeholders sufficient visibility to plan for needs,
support research and foster the development of the pharmaceutical
industry.
Better data for better decisions
Establishing accessible national databases on the costs of care,
together with traceability of medical and pharmaceutical procedures, is
a priority. Reliable data would make it possible to assess patients'
actual needs more accurately, evaluate cancer-control policies and guide
resource allocation. It would also help strengthen transparency and
accountability in budget management.
This effort must be accompanied by improvements to public procurement
procedures. Purchasing rules should reflect the specific characteristics
of healthcare products in order to support strategic procurement,
anticipate needs more effectively and secure supply.
Better integrating pharmacists into the care pathway
Hospital pharmacists play an essential role within multidisciplinary
oncology teams, as already highlighted in the 2015--2019 Cancer Plan,
particularly in its fourth strategic area. Community pharmacists, as
accessible local healthcare professionals, can also help support
patients throughout their care journey.
It is therefore necessary to break down barriers between hospital and
community care, as well as between the public and private sectors.
Coordinated planning based on interdisciplinary cooperation can improve
equitable access to care and continuity of support. The community
pharmacy network should be part of this discussion, notably through a
prospective study of the feasibility and impact of health-insurance
reimbursement programmes for certain cancer therapies.
Towards a comprehensive and sustainable strategy
Funding cancer medicines alone cannot constitute a complete
cancer-control policy. An effective strategy must cover the entire care
pathway: prevention, screening, diagnosis, treatment and psychosocial
support. It must also address major risk factors and bring several
sectors together around shared objectives.
Finally, strategic monitoring is needed to track international
scientific, economic and regulatory developments and better adapt
national decisions. The long-term sustainability of the fight against
cancer in Algeria will depend on a comprehensive approach: planned
funding, reliable data, appropriate procurement and stronger cooperation
among all healthcare professionals.
ANPHA • Funding Challenges for Cancer Therapies