The first ever Lancet Oncology Commission report is being presented to the 2011 European Multidisciplinary Cancer Congress in Stockholm, Sweden. The Commission brings together 37 experts from High Income Countries in a comprehensive analysis that points out where these countries have lost their way in managing cancer costs, and future challenges.
The Commission was led by Professor Richard Sullivan from the King’s Health Partners Integrated Cancer Centre, a collaboration between King’s College London and its partner NHS Foundation Trusts – Guy’s and St Thomas’ and King’s College Hospital.
Cancer affects some 12 million new patients each year, causing 7.5 million deaths. With an ageing global population and an endless conveyor belt of expensive new drugs and technologies and increasing financial pressures, the cost of cancer care in high-income countries is becoming unsustainable and urgent solutions are needed, say the report authors.
Professor Arnie Purushotham, Director of King’s Health Partners Integrated Cancer Centre and a co-author of the report, says, ‘There is acknowledgment that the economic burden of health care in general, and high-quality cancer care in particular, will become unaffordable without genuine effort to address these issues. It is important to understand the drivers contributing to the burgeoning cost of cancer care and develop policy to address these factors.
While some issues are very specific, such as the huge development costs for new cancer medicines, other cost drivers are common across the spectrum of cancer care, such as over-use, rapid expansion of demand, and shorting life cycles of medical technologies: both drugs and imaging techniques. There has also been a tendency towards more defensive medical practice, a less informed regulatory system, and a declining degree of fairness to all patients with cancer.
The authors identify a whole range of immediate and medium term measures that need to be introduced to reduce the current cost base of delivering cancer care and manage the future cost curves of particularly expensive interventions such as cancer medicines. Radical action is needed to simplify and integrate patient treatment pathways, new models of care with lower cost bases need to be implemented and a whole new approach to expensive interventions – from mandatory cost effectiveness analysis, to the prohibition of off-label use and new economic models for reimbursement and incentivisation – must be driven through healthcare systems.
Educating the public, patients and policymakers about the key issues in delivering affordable cancer care is also essential, say the authors.
Professor Richard Sullivan said: ‘We are at a crossroads for affordable cancer care, where our choices – or refusal to make choices – will affect the lives of millions of people. Do we bury our heads in the sand, keep our fingers crossed, and hope that it turns out fine, or do we have difficult debates and make hard choices within a socially responsible, cost effective, and sustainable framework? The consensus from all those involved is that policy makers, politicians, patients, and health care professionals need to address this issue now’.
‘We believe that value and affordable cancer care can be introduced into the cancer policy lexicon without detracting from quality, and that the management tools, evidence, and methods are available to affect this transformation across all developed countries.
‘The global challenge to countries is how to deliver reasonably priced cancer care to all citizens – i.e. make cancer care affordable to individuals and society,’ he concluded.
The full report can be accessed here: http://press.thelancet.com/tlocomfull.pdf
Also at the European Multidisciplinary Cancer Congress in Stockholm, Sweden
At this week’s Congress, Dr Meike Van Hemelrijck from the Cancer Epidemiology Group at King’s will present the results of a study into the link between high blood pressure and risk of developing cancer.
Notes to editors
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