Can we Continue to Afford Access to Cancer Treatment?

Wilking, Nils; Lopes, Gilberto; Meier, Klaus; Simoens, Steven; Harten, Wim H. van; Vulto, Arnold G.

doi:10.17925/eoh.2017.13.02.114

Cited by 26 publications

(28 citation statements)

References 36 publications

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“…The current situation and consequences of reaching the sustainability ceiling (where costs of treatment outweigh the benefits), including definitions of sustainability and value, are discussed further in the first and second articles in this series of three perspectives. 4,5 To regulate spending and allow continued -or even improved -access to cancer treatments, changes must be made before the sustainability ceiling is reached. 4,5 As detailed in the first two articles of this series, the continuing exponential rise in costs is driven, in part, by the introduction of a large number of new, high-cost treatments.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 To regulate spending and allow continued -or even improved -access to cancer treatments, changes must be made before the sustainability ceiling is reached. 4,5 As detailed in the first two articles of this series, the continuing exponential rise in costs is driven, in part, by the introduction of a large number of new, high-cost treatments. Although innovation and research into new treatments should be encouraged, additional focus is needed on value-based medicine, characterised by evidence-based medicine, patient-centred care and cost-effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…Although innovation and research into new treatments should be encouraged, additional focus is needed on value-based medicine, characterised by evidence-based medicine, patient-centred care and cost-effectiveness. 4,6 The availability of additional safe, effective and affordable value-based options will enable health systems to expand access to beneficial treatments for more patients, free up resources for access to other medicines, and relieve pressure on healthcare budgets. 7 In this third perspective, we focus on solutions, providing potential options for sustaining cancer care and increasing access to treatments DOI: https://doi.org/10.17925/EOH.2017.…”

Section: Introductionmentioning

confidence: 99%

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Potential Solutions for Sustaining the Costs of Cancer Drugs

Lopes¹,

Vulto²,

Wilking³

et al. 2017

European Oncology &Amp; Haematology

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The growing burden of cancer urgently requires sustainable solutions to ensure continued access to effective and safe treatments for all patients within Europe. The aim of this article, the third in a series of perspectives, is to discuss potential approaches to sustain cancer care and increase patient access to treatments. Much work remains to ensure the sustainability ceiling (where costs of care exceed the benefits) is not reached. Immediate steps must be taken to avoid this, including patient education to encourage earlier diagnosis, use of treatment-response biomarkers, improving efficiency of healthcare systems, use of managed-entry agreements, introduction of value-based medicines with measurable outcomes and use of less expensive medicines. Here we discuss these potential solutions with a focus on reducing the cost of cancer drugs, using biosimilar medicines as an example. Biosimilar and generic medicines offer a cost-effective treatment option that may help combat the substantially increasing costs of cancer drugs. Competition from biosimilar medicines is expected to drive a decrease in the cost of medicines, resulting in increased affordability and access to therapy, and therefore a greater number of patients could be treated. However, various barriers must be overcome to increase the uptake of biosimilar medicines and education is needed to allay misperceptions and encourage greater use.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potential Solutions for Sustaining the Costs of Cancer Drugs

Lopes¹,

Vulto²,

Wilking³

et al. 2017

European Oncology &Amp; Haematology

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“…12,13 For instance, a study of over 19,000 patients with melanoma found that while first-line, molecularlytargeted combination therapy for B-Raf proto-oncogene serine/threonine kinase (BRAF)-mutated metastatic melanoma was registered in 75% of Western European countries and fully reimbursed in 58%, the same treatment was registered in 42% of Eastern European countries and only reimbursed in 18%. In Eastern Europe, most patients are still treated with palliative chemotherapy that does not prolong overall survival.…”

mentioning

confidence: 99%

“…The first paper addresses the reasons why the cost of cancer care is increasing and why this may be unsustainable unless changes are made. 15 …”

mentioning

confidence: 99%

What Happens when the Cost of Cancer Care Becomes Unsustainable?

Simoens¹,

Harten²,

Lopes³

et al. 2017

European Oncology &Amp; Haematology

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Cancer places a heavy burden on healthcare systems. The cost of cancer drugs is increasing, driven largely by the introduction of new, ever more innovative cancer treatments. This raises questions about value for money and the future sustainability of cancer care, and presents significant challenges for decision-makers in providing all patients with access to treatments and effective new cancer medicines. The aims of this article are to provide an understanding of how sustainability in cancer care is defined, what signs indicate that the limits of sustainability are being reached, and what potential impact this may have on patients with cancer within Europe. Each country is faced with making difficult decisions about the allocation of healthcare resources to cancer care, to best meet the health needs of their patients. Determining the value of individual cancer drugs can help to inform these decisions, because premium pricing for incremental innovation is no longer sustainable. When the cost of cancer care becomes unsustainable, countries may be forced to restrict health expenditure by limiting demand, cutting spending and reducing investment. This can lead to restricted access to treatment. New, innovative cancer treatments must provide greater value than current options, and measures are needed to contain and reduce expenditure and make best use of scarce resources, without impeding access to effective and safe treatments for all patients.

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Just Caring: Precision Health vs. Ethical Ambiguity: Can we Afford the Ethical and Economic Costs?

Fleck

2022

Human Perspectives in Health Sciences and Technology

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Many see “precision medicine” and “precision health” complementing one another. Precision medicine is critical when we have a life-threatening cancer that could be managed with a targeted cancer therapy. Still, we would rationally prefer whatever medicine might offer that would either prevent the emergence of that cancer or treat it in its earliest stages, the goal of precision health. Dr. Raza, an oncologist, argues in a book titled “The First Cell” that we should abandon paying for targeted therapies for metastatic cancer, and use that money to detect cancer up front using “liquid biopsies” to identify cancer cells in the blood at $500 each, or $100 billion per year. However, I argue that this would be neither a wise nor just use of limited health care resources. Granted, targeted therapies for most patients yield costly marginal gains in life expectancy. Still, we would be sacrificing identified lives for the statistical lives we hoped to save with liquid biopsy tests. We could do Whole Genome Sequencing of the entire population at $3000 per person, looking for the 10% of the population with a heritable cancer, again neither a wise nor just use of limited health care resources. We could fund research to identify biomarkers that would identify cancer patients who would be strong responders to targeted therapies and deny these therapies at social expense to moderate responders. The money saved could be used for targeted precision health efforts. What is really fair? Answering this question requires developing processes of fair and inclusive rational democratic deliberation. What choices are our healthy selves willing to pay for and live with if we develop cancer?

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Can we Continue to Afford Access to Cancer Treatment?

Cited by 26 publications

References 36 publications

Potential Solutions for Sustaining the Costs of Cancer Drugs

Potential Solutions for Sustaining the Costs of Cancer Drugs

What Happens when the Cost of Cancer Care Becomes Unsustainable?

Just Caring: Precision Health vs. Ethical Ambiguity: Can we Afford the Ethical and Economic Costs?

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