World face inequalities in access to cancer treatment

Cancer :: World face inequalities in access to cancer treatment

Patients around the world face stark inequalities in access to cancer treatment, according to a report published today (Thursday 10 May) in the cancer journal, Annals of Oncology. The report's authors urge decision makers in every country to take action and ensure that everyone has equal access to new cancer drugs when they are needed, wherever they live.

The report by Dr Nils Wilking, clinical oncologist at the Karolinska Institute in Stockholm, Sweden, and Dr Bengt J?nsson, director of the Centre for Health Economics at the Stockholm School of Economics, updates and improves on an earlier report by the same authors published in 2005.

The new report covers 25 countries, including Australia, Canada, New Zealand, Japan, South Africa and the USA, as well as 19 European countries, with a total population of 984 million, and it looks at access to 67 innovative cancer drugs. It reveals that Austria, France, Switzerland and the US are the leaders in the use of new cancer drugs, with France replacing Spain among the top four since the 2005 report was published.

The authors report that uptake of new cancer drugs is "low and slow" in New Zealand, Poland, Czech Republic, South Africa and the UK.

Dr J?nsson said: "The greatest differences in uptake were noted for the new colorectal and lung cancer drugs: bevacizumab, cetuximab, erlotinib and pemetrexed." (Lung and colorectal cancer are among the world's top cancer killers for both men and women [2]). The USA's uptake of bevacizumab for colorectal cancer was ten times the uptake of the European average. In Europe, Austria, France, Germany, Spain and Switzerland had uptake that was higher than the European average; Denmark, Hungry, Norway, Poland and Sweden had low uptake; and Italy and the UK had very low uptake. The uptake of cetuximab was highest in France and the USA and low in Finland, The Netherlands, Poland and Sweden. For lung cancer, uptake of erlotinib was ten times higher than the European average in the USA and three times higher in Germany. Uptake in Australia, the UK, Norway and Poland was low. For pemetrexed, France and the USA had a high uptake and Canada, Czech Republic, New Zealand, Poland and the UK had a low uptake.

Dr Wilking said: "Progress in medical treatments has meant that over half of the patients diagnosed with cancer will now be 'cured' or die from other causes. However, these benefits are only realised once the drugs get to the patients. Our report highlights that in many countries new drugs are not reaching patients quickly enough and that this is having an adverse impact on patient survival. Where you live can determine whether you receive the best available treatment or not. To some extent this is determined by economic factors, but much of the variation between countries remains unexplained.

"In the US we have found that the survival of cancer patients is significantly related to the introduction of new oncology drugs. From a European perspective, we have found differences in access reflected in patient outcome in the five major western European countries: France, Germany, Italy, Spain and the UK."

Of these five European countries, France had the highest five-year survival rate for all cancers (apart from non-melanoma skin cancer): 71% for women and 53% for men. Spain had five-year survival rates of 64% and 50% respectively, in Germany it was 63% and 53%, in Italy 63% and 48%, and the UK had the lowest at 53% and 43% respectively. The report also shows that in France, Spain, Germany and Italy 51-52% of cancer patients were treated with drugs launched after 1985, but only 40% of patients in the UK had access to these drugs.

Dr J?nsson said: "Around one sixth of the differences between these five countries in five-year cancer survival is due to differences in the uptake of new drugs in each country."




(Cancer :: World face inequalities in access to cancer treatment published at SpiritIndia on Thursday, May 10, 2007)

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