A new report highlights that misconceptions about the cost-benefit of innovative cancer treatments, less funding, and the shift of cancer research away from Europe could jeopardize the trajectory of improving survival rates and quality of life for patients.

A white paper, The Transformative Value of Cancer Medicines, commissioned by EFPIA and published by the Dolon Institute, calls for a renewed approach to cancer innovation and the value it delivers for patients and for Europe. The report highlights that siloed thinking between payers, health systems and finance ministries has led European governments to significantly underestimate the true impact of new oncology treatments. 

The report shows that advances in cancer care have significantly improved outcomes for many types of cancer, alleviated economic pressure on healthcare systems, driven economic growth, and created value beyond their direct costs:

• Contributing to1 million extra Quality-Adjusted Life Years (QALYs), which represent years of life gained in good health from advances in cancer care, diagnostics, and treatments.
• The total value of health gains driven by pharmaceutical innovation amount to €29.2 billion, underscoring the immense societal return from investing in cancer advancements.
• Bringing €53.7 billion Gross Value Added (GVA) to the European economy.
• Creating 49,400 jobs in research and development in Europe through investment in oncology alone.

Despite cancer representing 17% of Europe’s disease burden and causing nearly a quarter of all deaths, only 6% of health expenditure is allocated to cancer — with just 2.97% directed toward cancer medicines.[1]^,[2],[3]This chronic underinvestment fails to match the impact treatments have had and the true burden of the disease.

Between 1989 and 2022, advances in cancer care, diagnostics, and treatment prevented an estimated 5.4 million deaths across Europe, proving to be a high-impact investment for health systems and transforming millions of lives.[4]

Despite one in four Europeans facing a cancer diagnosis, concerns from policymakers and health service payers have emerged in recent years about increasing pharmaceutical expenditure on cancer in comparison to other therapeutic areas.[5]

However, new analysis in the report suggests that given the true value and return on investment of cancer therapies, innovation in these areas should be a cornerstone of health policy and of Europe’s broader economic strategy.

The report warned that access to innovation is slowing. The EFPIA W.A.I.T. indicator shows that the availability of oncology medicines has declined by around 14% falling from 58% in 2020 to 50% in 2024[6]^,[7]. Over the same period, median reimbursement delays increased by 15% between 2022 and 2024, rising from 469 to 540 days, leaving many of the 3.2 million cancer patients in Europe without timely access to effective medicines.^7,[8],[9] Insufficient funding and bureaucratic hurdles were identified as key drivers of this trend.

The report authors call on EU Institutions and EU Member States to address shortfalls in funding and ensure policy levers such as the EU Beating Cancer Plan are used to improve patient access to innovative medicines as a top priority.

In Spain, it is estimated that for every year of life gained through cancer medicines between 2000 and 2016, the cost was €3,269.[10] This is significantly lower than the cost-effectiveness threshold set by the Spanish Government, of €22,000 - €25,000 – demonstrating that new cancer treatments are providing better value than is understood.[11] Therefore, the report encourages further research into every Member State to ascertain the cost versus benefit of cancer drugs.

Cancer represents a growing public health crisis and remains an area of significant unmet need. In melanoma, novel immune checkpoint inhibitors have raised survival from just 5% at five years to as high as 52% at ten years.[12]^{,[13],[14],[15],[16],[17],[18]}

However, the report argues that innovation in cancer care should be expanded and accelerated, due to the high number of cancer types for which prognosis is poor and treatment options remain limited. For example, oesophageal, liver, pancreatic and lung, as well as many rare forms of cancer.

Growing scrutiny over oncology spending and misconceptions about the value of new medicines are hampering innovation. At the same time, Europe is losing ground globally: its share of cancer clinical trials has fallen to 20%, while China now accounts for 39%.[19]

Although policymakers have launched several initiatives to strengthen Europe’s response to cancer, including Europe’s Beating Cancer Plan and the EU Cancer Mission, these efforts have not been enough to turn the receding tide of access to medicines.

The report makes the following recommendations:

1. Maintain commitment to the Europe’s Beating Cancer Plan beyond 2025 and align with the EU Cancer Mission’s ambitious goal to improve the lives of 3 million people by 2030, backed by dedicated EU health funding (such as EU4Health), which is now at risk of being withdrawn.
2. Strengthen European competitiveness in research and development by ensuring sustained funding and support for innovation, not only to directly benefit patients, but also because supporting the uptake of cancer innovation reinforces the competitiveness of the European life sciences ecosystem on the global stage.
3. Prioritise addressing patient access by accelerating and ensuring equitable availability of new oncology medicines across Europe.

Nathalie Moll, Director General, EFPIA, said:

“Despite major scientific advances, cancer continues to be one of the major causes of early death and poor health for Europeans; we still have much more to discover before we can change this picture.

However, we also continue to observe worrying trends, including the continued displacement of cancer clinical trials away from Europe, as well as misconceptions about the cost-benefit of cancer treatments.

We encourage policy makers to carefully analyse the cost and benefit of cancer treatments and choose to invest in the next wave of cancer innovation to secure better outcomes for patients, or allow progress to move elsewhere.”

Claus Zieler, Chief Medical and Commercial Officer, Astellas Pharma said:

“I’m proud to be part of an industry that is driving innovation and transforming cancer care. But it is vital that we strengthen Europe’s position as a leader in life sciences innovation.

As this paper highlights, delays in reimbursement and underfunding are slowing patient access and the gap between Europe and other developed countries is expected to widen in the coming years, now is the time to act so that we can ensure better treatment outcomes for patients.

With over 100 cancer types requiring tailored approaches, innovation must be a cornerstone of health policy and Europe’s broader economic strategy.”

References:

[1] WHO. “Leading Causes of DALYs.” World Health Organization, May 2024.  https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys 

[2] WHO. “Leading Causes of Death.” World Health Organization, 2024. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death

[3] Dolon analysis of Manzano, Andrea, Christer Svedman, Thomas Hofmarcher, and Nils Wilking. “Comparator Report on Cancer in Europe 2025.” IHE Report, no. 2 (2025). https://ihe.se/en/rapport/comparator-report-on-cancer-in-europe-2025-disease-burden-costs-and-access-to-medicines-and-molecular-diagnostics-2/.

[4] Dalmartello, M., C. La Vecchia, P. Bertuccio, et al. “European Cancer Mortality Predictions for the Year 2022 with Focus on Ovarian Cancer.” Annals of Oncology: Official Journal of the European Society for Medical Oncology 33, no. 3 (2022): 330–39. https://doi.org/10.1016/j.annonc.2021.12.007.

[5] WHO. “Up to a Quarter of Europeans Will Develop Cancer: From Prevention, Early Diagnosis, Screening and Treatment to Palliative Care, Countries Must Do More.” World Health Organization, February 2020. https://www.who.int/europe/news/item/04-02-2020-up-to-a-quarter-of-europeans-will-develop-cancer-from-prevention-early-diagnosis-screening-and-treatment-to-palliative-care-countries-must-do-more.

[6] Newton, Max, Kirstie Scott, Marco Travaglio, and Per Troein. “EFPIA Patients W.A.I.T. Indicator 2020 Survey.” EFPIA, April 2021. https://www.efpia.eu/media/602652/efpia-patient-wait-indicator-final-250521.pdf

[7] Newton, Max, Kelsey Stoddart, Marco Travaglio, and Per Troein. “EFPIA Patients W.A.I.T. Indicator 2024 Survey.” EFPIA, May 2025. https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf.

[8] Manzano, Andrea, Christer Svedman, Thomas Hofmarcher, and Nils Wilking. “Comparator Report on Cancer in Europe 2025.” IHE Report, no. 2 (2025). https://ihe.se/en/rapport/comparator-report-on-cancer-in-europe-2025-disease-burden-costs-and-access-to-medicines-and-molecular-diagnostics-2/

[9]Newton, Max, Kelsey Stoddart, Marco Travaglio, and Per Troein. “EFPIA Patients W.A.I.T. Indicator 2022 Survey.” EFPIA, April 2023. https://www.efpia.eu/media/s4qf1eqo/efpia_patient_wait_indicator_final_report.pdf  

[10] Lichtenberg, Frank R. “The Relationship Between Pharmaceutical Innovation and Cancer Mortality in Spain, From 1999 to 2016.” Value in Health 26, no. 12 (2023): 1711–20. https://doi.org/10.1016/j.jval.2023.08.011.

[11] Vallejo-Torres, Laura, Borja García-Lorenzo, and Pedro Serrano-Aguilar. “Estimating a Cost-Effectiveness Threshold for the Spanish NHS.” Health Economics 27, no. 4 (2018): 746–61. https://doi.org/10.1002/hec.3633

[12] NHS Foundation Trust. “Over Half of Advanced Melanoma Patients Treated with Combination Immunotherapy Drugs Survive the Disease for at Least 10 Years.” 2025. https://www.royalmarsden.nhs.uk/news-and-events/news/over-half-advanced-melanoma-patients-treated-combination-immunotherapy-drugs.

[13] Wolchok, Jedd D., Vanna Chiarion-Sileni, Piotr Rutkowski, et al. “Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced Melanoma.” The New England Journal of Medicine 392, no. 1 (2025): 11–22. https://doi.org/10.1056/NEJMoa2407417.

[14] Cardoso, F., S. Paluch-Shimon, E. Senkus, et al. “5th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 5).” Annals of Oncology: Official Journal of the European Society for Medical Oncology 31, no. 12 (2020): 1623–49. https://doi.org/10.1016/j.annonc.2020.09.010.

[15] Bidard, Francois-Clement, Virginia G. Kaklamani, Patrick Neven, et al. “Elacestrant (Oral Selective Estrogen Receptor Degrader) Versus Standard Endocrine Therapy for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer: Results From the Randomized Phase III EMERALD Trial.” Journal of Clinical Oncology, ahead of print, Wolters Kluwer Health, October 1, 2022. world. https://doi.org/10.1200/JCO.22.00338.

[16] Modi, Shanu, William Jacot, Toshinari Yamashita, et al. “Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer.” New England Journal of Medicine 387, no. 1 (2022): 9–20. https://doi.org/10.1056/NEJMoa2203690.

[17] Hortobagyi, Gabriel N., Salomon M. Stemmer, Howard A. Burris, et al. “Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer.” New England Journal of Medicine 386, no. 10 (2022): 942–50. https://doi.org/10.1056/NEJMoa2114663.

[18] Harbeck, Nadia, Frédérique Penault-Llorca, Javier Cortes, et al. “Breast Cancer.” Nature Reviews Disease Primers 5, no. 1 (2019): 66. https://doi.org/10.1038/s41572-019-0111-2.

[19] IQVIA. “Global Oncology Trends 2024: Outlook to 2028.” IQVIA Institute. Accessed July 11, 2025. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/global-oncology-trends-2024/iqvia-institute-global-oncology-trends-2024.pdf.