A checkpoint inhibitor immunotherapy treatment for cancer has been added to the World Health Organisation’s priority list of essential medicines.
Pembrolizumab (MSD; Keytruda) was added as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic NSCLC.
For metastatic NSCLC, atezolizumab (Roche; Tecentriq) and cemiplimab (Regeneron; Libtayo) were also included as therapeutic alternatives, WHO said.
Increased access to PD-1/PD-L1 immune checkpoint inhibitors was generally recommended as part of a broader effort to reduce disparities in cancer care.
As the second leading global cause of death, cancer treatments have been a major WHO focus over the past ten years, the organisation said.
“With cancer medicines accounting for about half of all new drug approvals by regulatory agencies, the Expert Committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit,” it noted.
Only medicines proven to prolong life by at least 4-6 months are included on the essential medicines lists (EML) for adults and children.
The Committee also endorsed evidence-based clinical and health system strategies, such as dose optimisation, to help improve access to and affordability of cancer treatments.
“The committee emphasised that while health system reforms require time and government action, clinical strategies can be implemented immediately to deliver faster benefits, especially in resource-limited settings,” WHO said.
However, the addition of immunotherapies such as pembrolizumab to the list has provoked some controversy due to their significant price and the danger that the cost will continue to limit access, according to an article in the BMJ [link here].
Some argue that listing the medicines as essential could drive down prices and allow bulk procurement to increase accessibility, the article said, but they could also take away space for more affordable treatments.
The WHO acknowledged that pricing remains an important concern.
“A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” WHO Director Policy and Standards for Medicines and Health Products Deusdedit Mulbangizi said in a press release.
“Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind,” he added.