By Peter Naredi, President of the ECCO Board of Directors (2016/2017)
When did the first debate on access to novel forms of cancer treatment start? Was it with the advent of mastectomy in the 1880s? The development of radiotherapy in the 1890s? Or the burst of new pharmaceutical treatments after World War II?
Perhaps the argument is academic. For each time science takes a step forward in fighting cancer, attention turns to how to ensure uptake of, and access to, the progress. Who wants to be back of the queue when an advance in treatment has been made?
So today’s environment, with exciting advances in cancer care still occurring, is in some respects also familiar - albeit that, even allowing for inflation, the price tag attached to some emerging personalised treatments would make a healthcare payer’s eyes water in any era.
As with cancer itself though, just because we are familiar with a particular challenge should not mean that we stop searching for new solutions. With this in mind, the European CanCer Organisation (ECCO) recently brought together its 25 member societies to establish key areas of consensus for policy progress on access to innovation. Amongst other central points, our most recent policy position entitled 'Identifying critical steps towards improved access to innovation in cancer care' explains to health system decision makers that:
- structured pathways are required to systemise the introduction of innovation within health systems;
- patient benefit must be at the heart of valuing an innovation;
- real world data should help assess innovation benefit beyond the pharmaceutical domain, for example in relation to potential improvements from innovation in surgical techniques, medical devices or new professional services; and,
- a whole-system approach to innovation should be promoted via multi-disciplinary leadership (e.g. reviewing current practices and identifying improvement opportunities).
Though the paper delves wider, it does not pretend to offer solutions to all access issues. Instead, it provides new mandate for ECCO to coordinate its members’ views in acting for the patient, and seeking an environment where we can be more confident that scientific advances in treating cancer will benefit the many, not the few.
The debate on access to cancer care has always been vital, in the truest meaning of that word. However, with new treatment costs arguably increasing out of all proportion to the science, our ethics as healthcare professionals precludes us from staying silent on the matter.
The economics of cancer care joins organisation of cancer care as a fundamental ECCO concern.
The ECCO position paper ‘Identifying critical steps towards improved access to innovation in cancer care’ is published in the European Journal of Cancer (vol 82, pp 193–202), and is freely available online at bit.ly/ECCO_access
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