Despite significant therapeutic advances, cancer continues to exact a heavy toll on individuals, societies and economies, and by 2035, it will have a predicted economic impact of €100 billion per year in Europe alone. The need for cooperation between countries and optimisation of oncology policy has never been stronger. Against this backdrop, at the 2022 European Health Forum Gastein, an expert panel convened to discuss the lessons learned from recent experiences, and the development of effective oncology policy for the 2020s and beyond.
This panel consisted of two grantees from Cohort 3 of the MSD Global Oncology Policy Grant Programme – Prof. Dr. Oliver Kessler (Lucerne University of Applied Sciences and Arts) and Dr. Clara Volintiru (Bucharest University of Economic Studies) – alongside leading experts in oncology policy: Dr. Bettina Ryll (Melanoma Patient Network Europe), Mr. Alexander Roediger (MSD), and Mr. Stefan Schreck (European Commission). The present blog highlights the key themes and insights discussed at this event.
"Despite significant progress in our understanding and treatment of oncology over the past decade, reducing the burden of cancer remains a key global policy priority. The COVID-19 pandemic has illustrated the power of collaboration and coordinated action in addressing global health needs. Similar approaches are needed in oncology as we aim to balance the need for innovative oncology therapies with equitable access to medicines across countries." – Dr. Panos Kanavos (Associate Professor in Health Policy – London School of Economics and Political Science)
To start, audience members were asked to estimate what proportion of health expenditure in the EU goes into cancer care. The majority overestimated and responded 9-13%. The true value is in the range of 4-8%, although the inclusion of intangible and indirect costs may well increase costs significantly. Despite uncertainty, as costs increase it is clear that maximising the value of new and existing cancer treatments will be critical.
This imperative motivates Oliver Kessler’s work, which was discussed next, and looks at the social and economic value of integrated cancer treatment in Switzerland. Oliver’s conclusions suggest the need for a paradigm shift away from cost-containment and towards value creation and evidence-based investment in healthcare. At both a macro and individual level, one of the most important, but difficult, progress points is the transition away from silo-based working towards integrated cancer policy and care including prevention, diagnosis, treatment and therapies, and palliative care, and which center the patient across the entire pathway.
One major policy change Prof. Kessler advocates for is the redirecting of funds into prevention and early detection. This is in line with the work of the Cancer Mission Board, discussed at the event by Bettina Ryll. Dr. Ryll stressed the importance of a holistic approach, focusing on prevention but also ensuring there is effective management and treatment of the failed prevention efforts of the last few decades with equity both across and within countries.
The audience was then tasked with choosing the three stakeholder groups experiencing the highest socioeconomic burden of cancer. The majority chose patients, caregivers/families and national healthcare systems. Clara Volintiru’s work on the microeconomic impact of cancer on the patient, the mezzo-economic impact on the patient and ‘family hub’ and the macro-economic impact on the Romanian economy mirrors this. Dr Volintiru determined that the value lost to the economy per year as a result of cancer patients, and their caregivers, being out of the workforce for periods of time is equal to 3% of GDP, equivalent to the entire allocation earmarked for education.
Next, audience members were asked to determine what the EU can add to the cancer response that individual Member States (MS) cannot achieve alone. Almost all audience members (82%) agreed that the EU can assist with measuring progress and differences among MS, setting regional targets on patient outcomes in cancer, and creating regional best-practice guidelines and recommendations.
This underlines the importance and promise of the European Cancer Inequalities Registry, which was highlighted by Stefan Schreck as a “daring experiment” to collect, analyze and disseminate data so that policymakers and other stakeholders can understand where inequities exist and how they can leverage resources to solve for them. He stated that the registry will “…make inequalities in this area measurable, which makes it much easier to invest in them”.
The Registry is a part of the European Commission’s Beating Cancer Plan. This well-funded multi-stakeholder initiative is an EU-wide approach to the cancer pathway, incorporating important aspects of prevention, treatment and care. It represents the first step towards a European Health Union with countries working together to improve prevention, treatment, and aftercare for cancer and other diseases via, for example, EU-wide shared frameworks, training, best practice guidelines or joint procurement and financing of medicines.
“We’re committed to keeping patients at the center of everything we do – we’re excited about the Europe’s Beating Cancer Plan’s emphasis on empowering patients to make well-rounded health decisions by improving health literacy.” - Alexander Roediger (Executive Director – Global Oncology Policy Lead – MSD)
Closing the session, a fruitful Q&A session centered around the future of cancer care. Panellists were hopeful, citing the exciting opportunities arising in innovative treatment as a result of our increased understanding of the human genome. They also remained realistic, stressing the importance of effective, evidence-informed policy. Finally, the panel reached a consensus: to ensure that the power of collaboration and coordinated action to address global health needs is not lost as we move into a post-COVID era, we must continue to develop cancer policy that encourages bottom-up expertise to flow into European decision-making and promotes multi-stakeholder collaboration, for the good of all populations.
George Wharton is a Senior Lecturer in Practice at the LSE Department of Health Policy.
MSD Project members: Mackenzie Mills, George Wharton, Dr Jennifer Gill, Dr Panos Kanavos, Prof Elias Mossialos
DISCLAIMER
Through the Global Oncology Policy Grant Program, MSD funds independent health policy research to improve cancer care and outcomes for patients worldwide. This programme is a collaboration between LSE and MSD.