The new Pharmaceutical Strategy for Europe
On 25 November 2020, the European Commission adopted its new Pharmaceutical Strategy for Europe, based on the following key pillars:
- Fulfilling unmet medical needs and ensuring accessibility and affordability of medicines
- Boosting industry competitiveness, innovation and sustainability
- Building crisis preparedness and response mechanisms and diversified supply chains capable of addressing medicine shortages
- Fostering the EU’s global leadership by promoting a high level of quality, efficacy and safety standards.
The Strategy includes several references to cancer and unmet needs in the field. In particular, it highlights the complementary nature of the Strategy and Europe’s Beating Cancer Plan, in ensuring that patients across Europe can access high-quality treatment and new therapies when they need them and safeguarding the availability and affordability of essential medicines for cancer patients across the EU. Cancer-relevant initiatives under the scope of the Pharmaceutical Strategy include a proposal to revise the legislation on medicines for children and rare diseases to improve the therapeutic landscape and address unmet needs (e.g. in paediatric cancer) through more tailored incentives by 2022. The Strategy also sets out to improve mutual learning and best-practice exchange on pricing, payment and procurement policies, including those related to cancer treatment, to improve the affordability and cost-effectiveness of medicines and health system’s sustainability by 2024.
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Recommendations to improve Quality of Life for all Cancer Patients and Survivors
During the European Cancer Summit (18-19 November 2020), the Survivorship and Quality of Life Network of the European Cancer Organisation launched its recommendations to help more cancer patients and survivors achieve a life truly free from cancer.
The Free from Cancer publication suggests seven priority areas including addressing cancer distress, management of pain and other symptoms as core parts of the cancer patient pathway and empowering patients and survivors. To address these needs, it recommends the below measures and actions among others:
- Embedding Survivorship Care Planning into every cancer patient’s pathway of care.
- Establishing a European survivorship professional certification to increase awareness and education of all oncology professionals on issues such as psycho-oncology, pain management, co-morbidity and sexual medicine.
- Including pain as core health indicator at national and European level
- Providing the European Agency for Safety and Health at Work (OSHA) with fresh mandate and instructions to improve workplace rights for cancer patients, survivors and their carers.
- Establishing in all European countries a “Right to be Forgotten” for cancer survivors in respect to financial service provision.
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BECA Hearing in December
The first December hearing of the European Parliament Special Committee on Europe’s Beating Cancer Plan (BECA) discussed the most common causes of cancer related to lifestyle, as well as prevention strategies with seven leading specialists in cancer prevention. Tobacco consumption, alcohol use, dietary behaviours, UV exposure, and HPV vaccination were among the major topics covered during this meeting.
The second hearing on 11 December focused on the environmental risk factors for cancer, including radiation, air pollution, exposure to chemicals and pesticides, and being exposed to carcinogens at work. More information about the hearings are available here and here.
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ECCO Roundtable on Lung Cancer
On 7 December 2020, the European Cancer Organisation held a Community 365 Roundtable Meeting on Lung Cancer on 7 December during which it launched the Essential Requirements for Quality Cancer Care: Lung Cancer position paper.
According to the position paper and roundtable discussions, high quality care standards should be established to tackle the wide variation in treatment and outcomes of lung cancer in Europe. Key steps include:
- Improving early diagnosis and screening
- Promoting equitable access to true multidisciplinary and multi-professional care
- Continuous performance measurement of outcomes and care is to create continuous improvement cycles
- Enhanced patient involvement, access to information and transparency
Access the roundtable recording and documents here.
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Let’s Talk Prostate Cancer Expert Groups calls for improved Prostate Cancer Care across EU
Let’s Talk Prostate Cancer Expert Group representing key prostate cancer stakeholder organisations has recently launched a Digital Atlas, a resource hub providing the latest data, analysis and information on prostate cancer to aid informed decision-making and policy development to improve prostate cancer care and outcomes.
In its call to action, the Expert Group highlights the considerable variance in patients’ access to multi-disciplinary and specialist care, as well as often neglected issues such as stigma, social isolation and poor help-seeking. It further demonstrates that countries which invest more in cancer care tend to achieve better patient outcomes, and calls on policy-makers to pay more attention to prostate cancer as the most frequently diagnosed cancer in men with a rising incidence rate. This should include a commitment by national governments to ensure specific and measurable prostate cancer targets are implemented in country cancer plans and that all EU Member States follow the European Association of Urology (EAU) clinical guidelines on prostate cancer.
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Access to Personalised Oncology in Europe
A new report by the London School of Economics and Political Science (LSE) identifies the barriers to better deployment of personalised cancer treatment for European cancer patients and makes concrete recommendations on how to advance and implement personalised oncology in Europe.
According to the report, challenges associated with personalised oncology (PO) include difficulties in effective evidence generation, regulatory issues including the lag between availability and access to innovative treatments, and variations in value determination and reimbursement policies across Europe. In order to facilitate innovation in personalised medicine area and maximise its significant potential to improve patient outcomes and foster patient-centred care, the report makes five policy recommendations:
- A European strategy on PO use in Europe
- EU harmonisation of ethics approvals to allow the sharing of anonymised, protected patient data
- Incorporation of ‘up-to-date’ information relevant to PO into medical curricula and into compulsory continued professional development (CPD) for practicing clinicians, while improving health literacy on PO
- Ensuring access to fully reimbursed, actionable mutation (biomarker) testing built into standardised patient pathways for all eligible patients
- Acceptance of newer trial designs such as basket and umbrella trials by HTA agencies.
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OECD Health at a Glance: Europe 2020
The 2020 edition of the OECD (Organisation for Economic Co-operation and Development) publication “Health at a Glance: Europe” provides the latest data on the burden of cancer in Europe and looks at the quality of care and patient experience for certain cancers.
According to the findings, lung cancer continues to be associated with relatively low survival after diagnosis. The overall mortality rate from lung cancer in 2020 is expected to be 54 per 100 000 population in the EU as a whole. The absence of any large-scale screening programmes impedes the detection and treatment of lung cancer at an early stage. As such, effective treatment remains difficult and the most promising approach to reducing lung cancer mortality is therefore to strengthen prevention to further reduce incidence.
In breast cancer, Western European countries have all attained a five‑year net survival of at least 80%, but net survival is still lower in several Central and Eastern European countries, despite increases in recent years. As the COVID‑19 pandemic severely disrupted breast cancer screening programmes and treatments in the first half of 2020, it is estimated that a greater proportion of women may be diagnosed at a more advanced stage.
Findings also reveal that cross-country variations in survival following a diagnosis of colon cancer are wider than for many other types of cancer. This suggests large differences in the capacity to ensure timely diagnosis and access to pharmaceuticals and other treatments for colon cancer.
Access the publication here.
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Challenges in Access to Oncology Medicine across the OECD and EU
A recent OECD Health Working Paper looks at the challenges of OECD and EU countries in providing and sustaining affordable access, against the backdrop of a surging number of patients being treated and rapid therapeutic advances in oncology. According to the publication, major challenges include uncertainties about the degree of clinical benefit at the time of market entry and coverage determination, the complexities of determining price and place in therapy of products with multiple approved indications reflecting variable degrees of clinical benefit and cost-effectiveness, and the pricing of products used in combination with other treatments.
Above all, many countries express concerns about their ability to reconcile access to oncology treatments with spending efficiency and sustainability. Data shows highly unequal access to oncology medicines across and within OECD and EU Member States. In response, the following policy options are recommended by the OECD:
- Minimising/eliminating patient contributions, and applying fixed co-payments rather than co-insurance with safety nets to preserve affordability and avoid catastrophic costs for patients and households.
- Strengthening the domestic information landscape through routine tracking of use by indication, to inform ex-post price adjustments, monitor expenditures and contribute to the gathering of the real world evidence on the performance of medicines.
- Improving the design of performance-based managed entry agreements to support the generation and collection of on-market data.
- Enhancing international collaboration and information sharing to improve countries’ collective capacity to address clinical and economic uncertainties.
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Event Report – EU Health Summit
The event report from the EU Health Summit, which took place on 26 October 2020, is available for download here.
Throughout the Summit, particular attention was paid to the lessons learnt from the COVID-19 pandemic and how to translate these into a political vision capable of maximising collaboration and ensuring a healthy and equitable future for everyone in Europe.
The 2020 EU Health Summit was a catalyst that enabled participants to reach a common understanding of the collaborative and concrete actions that all parties should take to improve Europeans’ health and sustainability in health systems going forward.
Over 600 participants gathered, together with thought leaders from the healthcare landscape, and discussed concrete actions to implement the 10 jointly developed recommendations.