An advance market commitment for PD-1 biosimilars for lower-income countries
Immunotherapy patents start expiring around 2028. Guaranteeing in advance to buy cheap copies for poorer countries would make sure manufacturers build the capacity.
Pembrolizumab and nivolumab lose key patent protection in major markets from about 2028; biosimilar developers are targeting high-income markets first, and LMIC supply may lag by years as it did for trastuzumab. Gavi's pneumococcal advance market commitment showed that a guaranteed purchase at a ceiling price can accelerate manufacturing investment for poorer markets. The proposal is a donor- and government-backed commitment to buy a defined volume of WHO-prequalified PD-1 biosimilars for LMIC programmes at a ceiling price (for example under $500 per dose) from 2028, with WHO prequalification and pooled procurement handling quality and distribution.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
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