OnCo
ideasIdea

One outcome record for every donated or discounted cancer drug pack

Companies and charities give or discount cancer drugs in poorer countries, but nobody records whether the patients did well. Make a simple outcome record part of every programme.

Access programmes (donations, tiered pricing, patient assistance) treat hundreds of thousands of patients in low- and middle-income countries with no systematic outcome data, so we cannot tell whether treatments developed in high-income trials work under different conditions of nutrition, comorbidity, diagnostics and supportive care. The proposal makes a minimal outcome record (diagnosis, stage, treatment, vital status at 12 months) a condition of participation, captured via mobile registry tools and pooled by a neutral steward.

Hypothesis
Outcome data from access programmes will show that effectiveness in LMIC settings differs substantially from trial results for at least some drugs, changing which drugs and supportive care are prioritised.
Rationale
Paediatric leukaemia programmes in LMICs showed that outcome tracking identified treatment abandonment and toxic death as the main problems, leading to protocol changes that doubled survival.
What would test it
Add the outcome record to two large access programmes for two years; report completeness and whether the data changed programme design.
Maturity
speculative
Who has to act
philanthropy
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks

Connected

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