Comparison of Availability and Accessibility of Oral Oncology Products between Medicare, Commercial U.S., and U.K. National Health Service (NHS) Patient Populations


Corresponding author: Lincy S. Lal. Email:


This paper explores some of the concerns associated with the new group of oral anti-cancer agents from the standpoint of availability, direct costs to the patient, and pricing strategies. We sought to evaluate the availability in the United States and the United Kingdom based on approval times. We then consulted select insurance companies' websites for 2011, the online Medicare Part D donut-hole calculator, and the Cancer U.K. website for cost information. Nine oral targeted agents are approved both in the United States and United Kingdom. The date of approval was earlier in the United States compared to the United Kingdom for every medication, and Medicare patients have the highest out-of-pocket payments. Oral oncology products are available earlier in United States than in United Kingdom. Potential high out-of-pocket liability for Medicare patients is a greater obstacle to access than is the case for U.S. commercial insurance or National Health System (NHS) patients in the United Kingdom.