Asia faces a growing burden in treatment costs due to rising numbers of patients diagnosed with cancer, as well as those suffering from stroke and dementia over the next decade.
While Asia’s economic progress has led to sharply lower levels of poverty, it has resulted in social and lifestyles changes ranging from diets to increasing urban pollution, that extract an increasing toll on communities.
The World Health Organization (WHO) says in Southeast Asia, late treatment of cancer results in 1.3 million deaths a year. WHO says of the 8.8 million deaths from cancer annually, two thirds are in Africa and Asia.
Cancers, along with diabetes, cardiovascular and chronic lung diseases, were responsible for 40 million – or 70 percent of the world’s 56 million deaths in 2015, WHO said.
But globally treatment costs are rising. In 2015, the spending on cancer drugs rose by 11.5 percent to $107 billion, and is forecast to rise to $150 billion by 2020 – due largely to the expense of newer and more specialized drugs.
The Boston Consulting Group said in a recent report the “cancer burden in developing countries is reaching pandemic proportions,” seen as a leading cause of death in India with some 2.5 million patients. They forecast that India has “a chance of the disease rising five-fold by 2025”.
China reported four million new cancer cases in 2016, with the national health bill set to soar “fourfold” to 12.7 trillion yuan ($1.84 trillion) by 2025, the consultants said.
Increased costs
Gregory Winter, a Cambridge University professor leading a research team in antibody engineering and modification technology for the treatment of degenerative diseases and several types of cancer, said while scientific progress has been made, treatment costs remain prohibitive for most populations.
“The challenges are much more in costs than in feasibility. I’m not saying everything is possible but I think in rolling [treatments] out to populations in general we will be struggling with cost problems. The cost of antibody treatment can be in the order of $15 to $75,000 per year and that’s a lot for anybody,” Winter said.
In China, reports say cancer patients and family care givers faced with the high cost of approved drugs lead to them seeking out generic drugs on the grey market to save costs. But the drugs may also be ineffective or fake.
Delays in China’s drug approval process has sometimes led to drugs coming onto the Chinese market up to 10 years after they appeared in the U.S. market. Winter says a similar story of delay is also found in India, and says a solution may require some countries in Asia to “take more risks during the drug approval process”.
“My own view is they should consider having a different drug approval process that is not so onerous and in return this should enable costs to be brought down for launching drugs in these markets,” Winter said.
Stroke and dementia
Asia is also facing rising health costs in the treatment of growing numbers of patients in Asia affected by strokes and dementia.
The WHO, in a 2012 report, estimated globally 35.6 million people worldwide living with dementia – with the numbers forecast to reach 65.7 million in 2030 and 115.4 million by 2050.
The report said nearly 60 percent of the burden of dementia is concentrated in low and middle income countries, and is expected to increase in the years ahead.
“The catastrophic cost of care drives millions of households below the poverty line,” with the numbers and economic burden making it a “public health priority,” the WHO said.
Canadian, Vladimir Hachinski, a leading global specialist in stroke and vascular dementia, at the University of Western Ontario, said a growing bank of evidence links high rates of pollution, evident across Asia, with strokes and dementia.
In 2016, research by Valery Feigin, a director of the National Institute for Stroke and Applied Neurosciences at Auckland University of Technology, set a clear link between air pollution and strokes.
Air pollution
The research found air pollution in the form of fine particulate matter ranked seventh in terms of impact on healthy lives.
The findings found the impact of air pollution in causing harm to the lungs, heart and brain had previously been underestimated.
“This is a global problem because there are currents between the continents. There are currents in the atmosphere that carry air from one continent to another and also within the continents. So what happens in Beijing matters in Bangkok because the whole atmosphere is one in the biosphere,” Hachinski said.
A recent report by the environmental group Greenpeace said as many as 1.2 million deaths occurred each year in India due to air pollution, just a fraction less than deaths from tobacco usage.
In China, cities such as Beijing continued to face regular bouts of choking smog during the current winter season amid high reported levels of harmful particle matter.
Studies indicate that smog leads to more than a million premature deaths in China each year, cutting life expectancy by two to five years.
Hachinski said Asia has to confront the issues of pollution as it faces a significant rise in pollution induced strokes, as well as dementia in increasingly ageing populations.
“At the rate we are going, we cannot afford more patients having strokes, more patients having dementia – particularly Asia – 61 percent of the world’s population is on Asia."
“In some countries like China, stroke is the leading cause of death and in Japan, of course, you have an aging population, you have high rates of stroke and dementia,” he said.
Sir Gregory Winter, Master of Trinity College University of Cambridge and Vladimir Hachinski, distinguished university professor at the University of Western Ontario in Canada, were recently recognized by Thailand’s Prince Mahidol Award Foundation for their contributions to medical science.
