The availability and affordability of safe, effective cancer therapies are core requirements for effective cancer control. Global disparities exist in access, however, yielding unequal cancer outcomes.
The goal of this study was to provide updated data regarding the formulary availability, out-of-pocket costs, and accessibility of cancer medicines in countries across the full spectrum of economic development areas.
The ESMO studies on the availability, out-of-pocket costs and accessibility of antineoplastic medicines aimed to collect data regarding the formulary availability, out-of-pocket costs, and accessibility of cancer medicines in countries across the full spectrum of economic development areas. The ESMO dataset serves as a valuable tool for identifying gaps in the accessibility and affordability of cancer medicines within national healthcare systems. It provides a foundation for designing targeted interventions to enhance access to cancer care services.
In 2025 ESMO has updated its global survey (published in 2017) of formulary availability, out-of-pocket costs, and accessibility of cancer medicines. The main results are reported in the figure below.
Over the past five years, there has been little progress in improving access to cancer medicines. This highlights a persistent global challenge that requires urgent attention – especially because the availability of anti-cancer medicines directly affects the daily practice of doctors and consequently their ability to care for patients with cancer.
ESMO will continue its efforts to support improving access to effective cancer interventions through its advocacy work at the European and global level.
The ESMO previous studies showed that internationally there is a growing disparity between licensed anti-cancer medicines and those that are actually available, leading to medicines shortages.
Data from the previous ESMO studies (2016 and 2017) has been valuable to the World Health Organization (WHO), who cited the studies as the most comprehensive assessment on the availability of cancer medicines globally in the 2018 WHO Technical Report on the pricing of cancer medicines and its impacts.
ESMO acknowledges and thanks all coordinating, collaborating and supporting project partners for their valuable contribution to this project which made it such a great success.