Access to Cancer Medicines in Kenya: A Scoping Review of Costs, Financial Toxicity, Quality of Life, and Policy Impacts

Background Cancer, Kenya’s third leading cause of death, imposes severe health and economic burdens, driven by high costs and limited availability of cancer medicines. However, the full evidence landscape remains unclear. In this scoping review, we synthesize evidence on cancer medicine access, financial toxicity (FT), Quality of life (QoL), and policy impacts for top five cancers in Kenya, to inform cancer treatment across health systems. Methods Following PRISMA-ScR guidelines, we searched PubMed, African Journals Online, Google Scholar, and grey literature (January 2018–May 2025) for studies on Kenyan adults with breast, cervical, prostate, esophageal, or colorectal cancers. Eligible studies on medicine access, FT, QoL, or National/Social Health Authority (NHIF/SHA) outcomes were screened using Rayyan software. Data was extracted into a piloted Excel form, and synthesized descriptively and thematically. Results Of 60 included studies, cancer medicines cost 3.15–162.42 days of minimum wage per chemotherapy cycle, exceeding WHO threshold. Availability was less than 50% in public facilities, with procurement delays (4–8 months) causing stockouts. Treatment costs for stage I–III cancers ranged from USD 1,340–1,542 in public versus 10,915–11,862 in private facilities. FT affected 20–54% of households, with over half (53.8%) abandoning treatment due to costs. QoL (addressed in 9/60 studies) scores (median 41.99–53) were poor, linked to FT and late-stage diagnosis (71% stage III/IV). Insurance coverage was partial, with SHA’s KES 400,000 cap showing potential to reduce costs despite underfunding and limited adoption of expert advice. Most studies lacked pricing (47/60) and catastrophic health expenditure data (53/60). Conclusions High costs, low availability, and inadequate insurance contribute to FT and poor QoL suggesting need for price regulation, expanded SHA coverage and longitudinal economic studies to address evidence gaps.