The new test for chronic myeloid leukemia can be run with a few dime-size spots on a paper card that can be mailed to a center for diagnosis.
Dr. Jerald Radich, a leukemia specialist at the Fred Hutchinson Cancer Research Center, said that since his lab developed the test cards have arrived by mail and in luggage from Africa and Asia, still useful after heat, cold and weeks in transit.
The test “began as a summer project for high school and college students in my lab,” Dr. Radich said. A major hurdle, he said, was finding paper that wasn’t so acidic or starchy that it degraded the RNA “marker” used to detect the disease.
Chronic myeloid leukemia, which in poor countries is often diagnosed late, when victims have distended spleens and soaring white cell counts, “was once a death sentence,” Dr. Radich said. But new drugs like imatinib — better known as Gleevec, introduced in 2001 — have kept many patients in remission for years.
Once they receive the diagnosis, patients from 80 poor and middle-income countries are referred to The Max Foundation, which helps them get drugs donated by Gleevec’s maker, Novartis, or other companies.
Dr. Radich began his quest for a simpler test in 2009, after Pat Garcia-Gonzalez, the foundation’s chief executive, attended a conference in Africa and learned that hundreds of potential aid recipients could not afford the $600 it cost to ship blood to diagnostic labs in Europe or the United States. An Ethiopian hematologist said some of his patients had sold their cows or homes to pay the shipping costs.
Gleevec, which made almost $5 billion for Novartis last year, has been at the center of a long battle between pharmaceutical companies and activists fighting price increases. The drug cost about $26,000 per year in 2001, and Novartis repeatedly raised the price even as competitors emerged; early this year, it was more than $120,000.
Those who support broader access to medicines argue that poor countries should reject patents and make generic versions of leukemia drugs. In 2013, India’s highest court struck down Novartis’s patent application for Gleevec, opening the way for generics. They now cost about $400 a year in India and about $9,000 in Canada.
One generic became available in the United States in February, but prices did not begin to soften until August, when more drugs were allowed on the market.
Novartis has placed no limits on how many doses it will donate, Ms. Garcia-Gonzalez said, but she sees the program as a “bridge” to the day when countries will be able to afford to pay for such drugs.
“We like it when the government has a stake in the patients being diagnosed correctly, getting the right drugs and doing well,” she said. “When the drug company is doing everything for free, it doesn’t matter to them.”