There were many take home messages from this session at the EHFG 2019, but to just state one would be very unfair. What was apparent, however, was that the development of a European cancer plan is desired, but we probably won’t see such a document anytime soon. Peter O’Donnell kicked off the session by outlining the agenda vocalising that a European cancer plan is European and not national. He outlined the need for key performance indicators (KPIs) in this area. Nils Wilking, Associate Professor, Institute of Health Economics, Karolinska Institutet, quickly followed presenting his comparison report on “Cancer in Europe 2019 – Disease Burden, Costs and Access to Medicines”. This will be available on the Karolinska Institutet website in November 2019 for those of you who are interested. Surprisingly, Nils reported that 42 – 45% of all cancers are preventable and that all EU countries roughly spend the same percentage of their healthcare budget expenditure on cancer medicines.
Tit Albreht, Lead, IPAAC Joint Action & Senior Health Services and Health Systems Researcher, Institute of Public Health, Slovenia, made a very important point that patient involvement was high in the design phase of cancer services, but decreased in the implementation and evaluation phases. This is contrary to public opinion in this field. We need to invest more in monitoring systems like France has.
Barbara Wilson, Founder of Working with Cancer, emphasised the importance of the survivorship still being on the agenda for discussion. However, she argued that cancer should be recognised as a disability and this is why disability adjusted life years (DALYs) are the most accurate health metric in economic evaluations which analyse cancer patients. Martin Seychell, Deputy Director-General, European Commission Directorate-General for Health and Food Safety (DG SANTE), scared us by saying that all projections show that cancer is the leading cause of death in Europe. He also talked about how Human Papilloma Virus (HPV) prevention in males can be overlooked in some European countries. Recently, in Ireland, the Health Information Quality Authority (HIQA) has recommended that a more effective version of the HPV vaccine be given to girls and extended to boys beginning in September 2019. Sometimes, as Ireland is not on the mainland, we can feel a bit disconnected from Brussels. However, we are implementing recommended EU health polices before other EU countries.
Mike Morrissey, Chief Executive Officer, ECCO and Kathi Apostolidis, President, ECPC engaged in panel discussions where it was stated that for a European Cancer plan to really work, EU member states must agree on and implement certain key universal rules in their own National Cancer Control Programmes (NCCP) and build on that. In Ireland, our NCCP was established in 2007 to ensure that all elements of cancer policy are delivered to the maximum possible extent. Our NCCP continues to reorganise cancer services to achieve better outcomes for patients. In fact, I was recently involved in a study where I argued that the subcutaneous trastuzumab formulation for the treatment of HER-2 positive breast cancer should be taken out of the secondary care setting and supplied to patients via their local pharmacy for self-injection at home. (1) This would reduce the loss of productivity for all involved as patients can avoid going to hospital. I believe it is this patient-centric rationale that should be entwined throughout the development of our future European Cancer plan.
This workshop was organised by European Cancer Organisation (ECCO), European Federation of Pharmaceutical Industries & Associations (EFPIA), European Cancer Patient Coalition (ECPC) and The Organisation of European Cancer Institutes (OECI) and moderated by Peter O’Donnell, Brussels correspondent, APM Health Europe.
- O’Brien GL, O’Mahony C, Cooke K, Kinneally A, Sinnott SJ, Walshe V, Mulcahy M, Byrne S. Cost Minimization Analysis of Intravenous or Subcutaneous Trastuzumab Treatment in Patients With HER2-Positive Breast Cancer in Ireland. Clinical breast cancer. 2019. https://doi.org/10.1016/j.clbc.2019.01.011
This blog was written by the Young Gasteiner Gary L O’Brien.