Dying to get a chance at life
DYING To Survive, a 2018 lowbudget movie from China will hopefully make history for saving many lives around the world.
Based on the real-life story of a Chinese leukaemia patient who smuggled cheap but untested pharmaceuticals from India to help hundreds of people suffering from cancer in China, the movie focuses on the inability to access expensive but effective cancer drugs which are widely available.
We in Malaysia share the same problem and heartache.
This popular emotional movie has forced a response from the government of China, whose subsequent renegotiations with the pharmaceutical industry has led to a reduction in the price of 17 lifesaving cancer drugs. In return, these corporations were offered greater access to the China market. Tariffs have been lifted and health insurance coverage has also been expanded to include these drugs.
Members of Together Against Cancer Malaysia, an organisation consisting of cancer survivors, prominent cancer specialists and researchers, were encouraged to see that Chinese Premier Li Keqiang was sufficiently moved by the movie to take action.
Financial toxicity due to cancer is not a challenge in China alone. The ASEAN Costs of Oncology (ACTION) Study showed that within one year of being diagnosed with cancer, 29% of patients in low- and middle-income countries in SouthEast Asia have died and a further 48% face financial ruin.
The principle investigator of the study from Malaysia, Associate Professor Dr Nirmala Bhoo Pathy who is also a committee member of Together Against Cancer, found that in this country, 46% of cancer-stricken households had used up their personal savings, with 22% being unable to pay their rent or mortgage and about 20% discontinuing their cancer medicine. This in turn may force them to face premature deaths.
For those with frequent contact with cancer patients, there is a recurring theme where fighting and surviving cancer can lead to impossible financial decisions. How do you reconcile impoverishing your family to acquire effective but unaffordable treatment? Will you be tempted by the cheaper, probably ineffective (and dangerous) alternatives on the Internet and elsewhere promising a miracle?
From my personal experience in Malaysia as a vice-president of the Quolin (Walking) Qikong Malaysia, a cancer survivors group with over 2,000 members, I have seen many advanced stage lung cancer patients suffer or die after they stopped responding to the first line therapies. Second line drugs offered to them can prolong life but may cost more than RM10,000 a month.
As vice-president of the Prostate Cancer Society Malaysia, I have seen many advanced prostate cancer patients who failed and/or become resistant to initial hormone therapy who could not get effective second line therapies to prolong life due to the high cost.
Dying To Survive highlights the great cost discrepancy between patented cancer medications and equally effective, generic drugs available at a tenth of the price. Unfortunately, accessing these drugs in China and Malaysia may not be in line with World Trade Organization (WTO) arrangements.
Dying To Survive touches on the basic moral fibre of humans; we should be striving to save lives and eliminate hardships among our fellow beings.
China, following Canada’s example, has renegotiated with the pharmaceutical industry to reduce the price of non-generic cancer medications. If Canada, with a population of 37 million, can renegotiate cancer medication costs, then Malaysia, with a population of 32 million, may be able to do so as well.
We hope the Health Ministry and the pharmaceutical industry will be able to agree upon a more do-able price structure to suit our patients’ paying capability and the country’s GDP. The ministry can also look into allowing faster registration of good quality generic cancer medications that will create healthy competition in drug prices within the country.
WONG KUAN SING President Together Against Cancer Malaysia