The Global Status of Access to Cancer Medicines : Mapping Access and Strategizing Barriers through Value-Based Prioritization

This thesis investigates global inequities in access to cancer medicines, integrating a multidimensional analysis of structural, regulatory, and practice-based barriers. Through an HTA policy review of the G7 countries, it highlights the divergences in decisional criteria and value frameworks guiding market access and reimbursement, revealing inconsistencies in priority-setting for innovative and essential cancer drugs.A global survey on medicine availability complements this, mapping gaps in access pathways across healthcare systems, with a particular focus on low- and middle-income countries. Further, a legislative study on the medical use of cannabis in oncology was conducted to expose normative and regulatory restrictions impeding patient-centered care, offering a paradigm to understand how legal frameworks influence therapeutic options.To ground this analysis in clinical practice, an in-depth case study on inflammatory breast cancer (IBC) care was performed, illustrating real-world, practice-based barriers in treatment delivery and access to novel therapies. This example underscores how local expertise, diagnostic delays, and fragmented care pathways exacerbate disparities even within advanced health systems.The thesis advocates for a value-based prioritization strategy, proposing a pragmatic framework to align drug accessibility with clinical benefit, health system sustainability, and equity. It calls for coordinated global action to harmonize evaluation processes, remove normative barriers, and recalibrate access priorities in oncology, ensuring that therapeutic innovation translates into meaningful, equitable patient outcomes worldwide.