#EUnited against inequalities in Cancer care (Guest blog)

Is it because I come from a small country and my family was touched by cancer and my relative couldn’t have access to the latest life-saving innovation in treating a rare form of melanoma because of her country of residence... Or is it my daily job where I collaborate with a team who work relentlessly for patient access to innovation in oncology, and we struggle every day to find solutions and bridge the inequality gaps ... Or is it due to COVID-19 pandemic that magnified the issue of inequalities and even widened the gap at every level in the healthcare delivery, in every country... Whatever the reason, inequalities in cancer care is a topic close to my heart, and now it is high on many agendas in Europe, and clearly highlighted in EU Beating Cancer plan. By joining all our forces and connecting the dots, we can make a difference for patients and citizens.
I often ask myself the question: Why would a patient with metastatic breast cancer living in Poland or Lithuania have access to an innovative medicine 2 to 3 years later than a patient with a similar disease living in Germany or Austria?

Even within breast cancer, patients with metastatic disease often don’t get equal opportunities for access to the care they need, due to multiple societal and healthcare system barriers.

Adding to that, for the past 2 years, Cancer diagnosis is in competition with COVID diagnosis, and today 1 million Europeans may be walking around with an undiagnosed cancer.
Within Europe, huge inequalities exist in time to market access and patient access to new oncology therapies, and the difference between both milestones lies in the value received by patients, once they are prescribed the treatment they need and can access it in the region where they live.

EFPIA’s report For patients, every day counts highlighted the significant disparities in market access and out of all oncology drugs that received marketing authorization, positive reimbursement ranges from as low as 7% to as high as 98%.

And furthermore, the report showed that after twelve months of formal reimbursement, the relative level of Patient Access ranges from as low as 22% to as high as 81%. The report depicts ten key barriers to patient access beyond affordability, ranging from process to reimbursement criteria and health system readiness. Plenty of opportunities for improvement here because every day counts for patients! 

Another important factor is public spending in health. It has grown slower than the GDP in the last few years, creating a challenge of underinvestment in health and in cancer care vs other sectors, and in Eastern countries vs EU5. The pandemic might have triggered politicians to pay more attention and start investing in health, however many questions come up around the source of funding, which healthcare sectors need it most and which reforms are needed to ensure sustainability. Ministers of health need to start talking with ministers of finance!

For all those reasons, we are witnessing a significant impact on patient outcomes in oncology. In a recent report published by EFPIA,  we see that breast cancer survival rates in Eastern countries have improved significantly but still lag behind EU5. For example, we see 5-year survival rates of 75% in Romania and 76% in Poland vs 86% in EU5, a 10% difference.

I’m calling out country names because we live in countries, and this is where patients receive their cancer care, not for naming, blaming, or shaming.
How do we solve this at Novartis?

In November of this year, we aim to #EUnite and join forces with many European stakeholders at the “Building Bridges, beating Cancer” Hackathon, to identify and support best practices and innovative solutions which bridge the inequalities in access.

Another example comes from a country, Poland, where the team co-created a digital platform fostering partnership and coordination between primary care centers and Oncology centers’ breast cancer units, and the purpose was to break the barrier of postal code cancer care and ensure proper patient navigation from diagnosis to treatment.

However, we need more systemic sustainable solutions, and with collaboration and coalition of good intents, we can get there.

My personal belief is that addressing the inequalities gap in breast cancer would not only improve the health outcomes of the patients but will improve the life of their family and caregivers and contribute to a healthier and more economically flourishing society.

Lamis Chahoud

Lamis Chahoud is currently Head of Market Access & Public Affairs at Novartis Oncology for Central, Eastern,...
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