Manuscript title: Trends in consumption and expenditures of targeted anticancer therapies in Tunisia

Abstract

Background

Targeted anticancer therapies have changed cancer care yet simultaneously imposed financial burdens on healthcare systems in Tunisia. This study aimed to analyze the national trends in consumption and expenditure of targeted anticancer therapies.

Methods

A retrospective analysis of national data from 2010 to 2021 was conducted to assess expenditure, consumption volume, therapeutic class distribution, and market authorization status.

Results

Over the study period, two distinct trends were observed in the use of targeted anticancer therapies. The volume number has increased markedly, with an increase in expenditures by 88% during the 2010–2017 period. Monoclonal antibodies dominated the market (70% of total spending in 2017). Then, between 2017 and 2020, the total expenditure decreased by 15% despite a 34% increase in unit consumption, and the market share of monoclonal antibodies (56%) and tyrosine kinase inhibitors (44%) became nearly comparable. These trends can be explained by the analysis of the number of market authorizations granted which increased during this period as well as the uptake of biosimilar and generics introduced in 2014 and the local manufacturing.

Conclusion

The Tunisian experience highlights the challenge of accessing targeted anticancer therapies while maintaining financial sustainability. Key strategies for ensuring sustainable and fair access to these innovative drugs include implementing pharmacoeconomic strategies, conducting continuous evaluations, introducing strategic market price revisions, price negotiations policies and promoting local manufacturing to ensure sustainable and equitable access to targeted anticancer therapies.

Policy summary

The growing use of targeted anticancer therapies in Tunisia has intensified financial pressures. This paper provides an analysis of the current national landscape of these drugs to inform policy solutions aimed at improving access and ensuring sustainability. Based on these findings, it proposes measures related to pricing, reimbursement, pharmacoeconomic evaluation, and the promotion of biosimilars and local manufacturing to support more sustainable and equitable access.