Three steps to better cancer outcomes

By applying the latest advances in treatment and medical knowledge, Europe has improved outcomes for people living with cancer. Prevention programmes, timely diagnosis, access to multidisciplinary care, and better treatments have all played their part.

On average, people with cancer are living longer than ever, and enjoying better quality of life. There are more cancer treatments available than ever before. Take lung cancer, for example. In the 20 years from 1996 to 2016, the number of medicines for treating people with lung cancer rose from 4 to 19.

Despite the burden of cancer being considerable and there are several barriers to getting the most out of the tools we have at our disposal.

More than 3.4 million people are diagnosed with cancer in Europe every year – and these numbers are on the rise. If trends continue, cancer will soon become the biggest cause of disease burden in Europe. While spending on cancer care has remained relatively flat across Europe, the predicted increase in cases means we need an immediate and serious dialogue about investing in health and cancer care.

There are other challenges to be worked on too. For some cancers, there is still an enormous unmet need where there is no effective treatment. Variation in access to screening, multi-disciplinary care and the latest treatments contribute to variation in results also known as outcomes for patients across Europe. Overall survival is on the up, but an individual’s fate can depend on where they live. Stark differences in outcomes between countries and within countries should not be acceptable in the modern era.

All of these challenges are solvable. To arrive at practical solutions that take in to account the perspectives of patients, health professionals and decision-makers, we need to have all the voices in one room. That is why EFPIA and its members initiated a pan-European conversation, involving over 150 cancer experts, including representatives from over 30 cancer patient organisations, more than 50 clinicians and more than 20 policy-makers, officials and payers.

Setting shared priorities
Together, this diverse group held a series of meetings to review a discussion document: Taking Action Together. These conversations produced three priorities for better cancer care, along with a range of potential solutions.
  1. Improving the sustainability and integration of cancer care
Coping with the growing burden of cancer in an ageing population is a serious challenge to health systems. In response, stakeholders call for the development of a good practice guide for resource allocation in health and in cancer care. If we believe in evidence-based medicine, we should embrace evidence-based decision-making in how we use scarce resources.
They also propose rigorous analysis of best practice in cancer service design across Europe; better data collection and usage; and the development of a shared vision of an outcomes-driven cancer service. Where change is required, the group calls for practical discussions on how this could be incentivised and encouraged.
  1. Accelerating the time it takes to get new treatments to patients
Improved access to clinical trials in the EU would bring innovative treatments to some patients. This is strongly supported by all stakeholders. To ensure these treatments reach as many patients as possible, a new model is needed that integrates regulatory approval and reimbursement decisions. A better understanding of how current systems work (and don’t work) in terms of access to medicines, quality of coverage and delays, is also urgently needed.
  1. Developing tailored pricing and reimbursement models for cancer medicines
A consensus framework for tailored access agreements is needed to identify good practice examples and continue to raise awareness of the importance of data infrastructure for these agreements.

Participants in the multi-stakeholder conversation propose a workshop to discuss the challenges of, and opportunities for, innovative approaches to combination treatments and how to handle patient access in terms of pricing and reimbursement.

Differential pricing is seen by many as a pragmatic solution to disparities in access to comprehensive cancer care. By working together to advocate for the benefits of differential pricing across Europe to patients – and highlighting the barriers preventing this from occurring – stakeholders could support a reimbursement model that tackles inequalities.

What’s next?
This is just the beginning a vital conversation. To find out more, read the working paper Taking Action Together.

Nathalie Moll

Nathalie Moll joined the European Federation of Pharmaceutical Industries and Associations (EFPIA) as Director...
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