Dra. Pilar Garrido López Spanish Society of Medical Oncology President

Transcription

1 Dra. Pilar Garrido López Spanish Society of Medical Oncology President

2 Cancer figures Global Data Incidence: new cases Mortality: cases Prevalence : cases Spanish data: - Incidence : new cases - Mortality: cases - Prevalence: cases Globocan IARC 2013

3 The burden of cancer: Current and future challenges Increasing cancer burden: Despite advances in cancer prevention, it has been estimated that by 2030, the number of new cancer cases will increase by 45% Growing ranks of cancer survivors: It is estimated that by 2022, there will be an increase of more than 35% *American Society of Clinical Oncology. J Oncol Pract Mar 1;10(2):

4 Facts Today s patients benefit from long-term investments in research As a result of this progress, more people with cancer are surviving now than ever before Progress in 5-year survival American Society of Clinical Oncology. J Oncol Pract Mar 1;10(2):

5 Challenges The demand for care is growing rapidly as a consequence of population growth, aging, and lifestyles New scientific, technical and economic trends are likely to alter oncology care delivery in the next 20 years more significantly than during the last 50 years

6 Cancer costs In 2013 alone, the FDA approved 18 new cancer treatment drugs, bringing the total number of more than 170 Annual cancer care costs are projected to rise from $104 billion in 2006 to more than $173 billion in 2020 American Society of Clinical Oncology. J Oncol Pract Mar 1;10(2):

7 Cancer costs II The average cost per month of branded oncology drug treatment in the U.S. is now about $10,000, up from an average of $5,000 a decade ago Judging the incremental value of these treatments for individual patients is fraught with challenges: high level of variability of patient response, frequent changes to protocol needed for patient care, equity Financial toxicity

8

9 Mortality rates in European countries Bose&. Ann Oncol 2013

10 Mortality rates in Europe With the major exceptions of female lung cancer and pancreatic cancer in both sexes, in the last quinquennium, cancer mortality has moderately but steadily declined across Europe However, substantial differences across countries persist, requiring targeted interventions on risk factor control, early diagnosis, and improved management and pharmacological treatment for selected cancer sites Bose&. Ann Oncol 2013

11 Annual average growth rate in per capita health expenditure

12 Different budgets, different results?

13 Report on approach to cancer costs in Spain, 2013 Total medical costs for cancer in 2012 account for 4.8% of total health care expenditures Expenditures in oncological drugs account for 6.6% of total pharmaceutical drug expenditures in Spain Oncological drugs represent 23% of total costs for cancer care Cost of oncological drugs is 40% lower than those for treating neurological, mental or cardiovascular disorders

14 Survey on drug accessibility SEOM 2013 Consecutive assessments Resource consumption and time investment Perceived sources of disparity DO YOU HAVE PROBLEMS IN PRESCRIBING DRUGS? NO puedo prescribir, 3 Puedo prescribir SIN Condiciones, 14 SI. Puedo prescribir con condiciones, 40 SI. NO PUEDO prescribir algunos fármacos, 21

15 Access to drugs in Medical Oncology. Report 2013 In some Autonomous Communities of Spain there are commissions, in some others there are not Whithin some of the commissions there are medical oncologists, in some others there are not In some of the commissions there are decisions which are not binding for certain hospitals of the same Autonomous Commmunity

16 Reports on therapeutic possitioning

17 Current situation The IPT is not binding The debate takes place at a micro level and not at a macro one. There are still assessments performed per autonomous community and pharmacy hospital committes Each time there are more intermediate steps required for incorporating new drugs to each individual hospital. Decision making atomisation and a lack of coordination strategies are triggering more access disparities The application of micro-approach formulae translates into a lack of equity and a waste of ressources

18 SEOM commitments

19 SEOM Commission on Pharmaceutical Drug Access. Elaboration of our own documents (IPTs SEOM). To be send to the Spanish Agency of Medicines and Medical Devicesl (AEMPS) Visibility on our SEOM web site. List of experts: Collaboration with the AEMPS, MSSSI and CCAA for revising the IPTs To gather the information on delays in pharmaceutical drug incorporation. A positionning documentation. Ex., SAS Framework agreement: 4001/13

20 Variability and measure Variability triggers inefficiency, lowers quallity and decreases safety: we ought to measure health related results There are many non pharmacological cost reduction measures that can be implemented : Management rationalization improves efficiency It is necessary to define and measure quality heath care service indicators. Standardized information A common methodology for efficiency assessment Detailed cost analysis capacity Sharing data

21 Promoting high-value care: Joint work with MSSSI in our Collaboration in the definition of Services and Referral Units (CSUR) of the National Health Care System (SNS) Collaboration at the MSSSI s Spanish National Strategy on Cancer Creation of the SEOM acreditación section

22 Recal-OM To elaborate a diagnostic on the situation regarding Medical Oncology Services in Spain To determine minimum common compulsory health care quality assistance indicators to be complied with all over Spanish territories Unit Benchmarking to foster their continuous improvement To develop, based on the previous analysis, quality improvement and efficacy enhancement SNS health care related proposals for better heath care of our cancer patients

23 Registry Agreements with the MSSSI and the GGCC for a follow up on drug effectiveness in cancer patients. Objective: to guarantee maximum efficiency of pharmaceutical care Commitments: To establish protocols To implement indicators to measure drug effectiveness

24 Biomarker Platform: SEOM-SEAP project Drug approvals for molecularly stratified tumor subgroups make molecular testing mandatory Ensuring that all patients effectively benefit from molecular testing Performing high quality tests Anticipate the launch of new molecules: be ready to perform the test as soon as the therapy is available Offer the best treatment to patients considering the cost effectiveness ratio

25 Patient s profile Higher educational level Access to health related information (Internet) Consumer rights oriented culture Active search for self care strategies Health perception as an individual good More participation in health care related decision making processes

26 Final Remarks SNS guarantees to all Spaniards access to services and provisions with EQUITY At the present time there are some restrictions due to measures taken to control expenditures To define, implement and assess COMMON health care indicators and COMMON quality measurement indicators is a PRIORITY We ought to ELIMINATE DISPARITES, reduce redundancies and get rid of unnecessary administrative and bureaucratic burdens

27 Final Remarks Physicians must join forces with insurers, policymakers, pharmaceutical companies, providers, and advocates to develop a complete equity system Equity is key: we can t afford different realities