European Week Against Cancer: Increase prevention, improve access
Improving access to cancer medicines can benefit from the actions of many stakeholders, writes Alojz Peterle.
Alojze Peterle | Photo credit: European Parliament audiovisual
European Week Against Cancer acts as a reminder that, despite more than 30 years of EU action on cancer control, the disease remains a major challenge. While we have made substantial progress in our efforts to tackle cancer, we cannot afford to be complacent.
We need to continue our efforts to prevent where we can and treat where we cannot. It is more than 10 years since I founded the MEPs Against Cancer (MAC) group, we increasingly see cancer as a problem that requires wider policy solutions that simply health.
European Week Against Cancer is an opportunity to remember the importance of prevention. This provides "the most cost-effective, long-term strategy for reducing the European burden of diseases". The European Code Against Cancer provides 12 evidence-based messages on prevention.
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As of 2016, 25 EU member states have some form of population-based breast cancer screening in place. Population-based cervical cancer screening programmes exist in 22 member states, while dramatic progress has been made in screening for colorectal cancer in the EU over the past 10 years.
Meanwhile, population-based colorectal screening programmes have been implemented nationally or regionally in 20 member states, with Germany ready to start a programme shortly. These are developments, of which we should be proud. Yet we can do more and must continue to support the member states.
However, too often, the focus on cancer treatments is on the new and the cutting edge. This is unfortunate, as it diverts attention from an area that should be a priority; access to inexpensive essential cancer therapies.
It needs to be more widely recognised that there are regular shortages of low cost cancer medicines within the EU. In Slovenia in 2014, around 60 per cent of pharmacies were experiencing weekly shortages. Other central and eastern European countries faced similar problems.
However, this issue affects virtually all countries in the EU to some extent. Even in well-funded healthcare systems, such as Germany, a number of the cancer treatments named on the WHO list of essential medicines (EML) are frequently not available.
Given the widespread nature of the problem, solving it requires coordinated policy action. However, there is a lack of information on precisely which drugs are in short supply. To an extent, this is compounded by the lack of a harmonised definition of shortages and standardisation of shortage notification systems and reporting mechanisms within the EU.
To address the first issue, the WHO has highlighted the need to develop a consolidated list of medicines in short supply or at risk of shortages, based on its EML, which includes 46 cancer therapies.
While many EU member states do not use the EML, believing that their healthcare system does not face such problems, the European Society for Medical Oncology (ESMO) recently found that many of the oncology treatment on the EML have been subject to shortages.
On the issue of harmonised definitions of shortages, this issue still needs to be addressed. However, the 2016 Heads of Medicines Agencies (HMA) a network of National Competent Authorities (NCAs) responsible for regulating medicinal products discussed the need to harmonise reporting procedures for medicines shortages at their 2016 stakeholder meeting. It called on NCAs to adopt a template that provides the same content, using the same format and the same trigger points for reporting shortages.
However, we should also focus on the positive; what has been achieved to date and what we are able to do in future. The European Commission's new joint action 'Innovative partnership for action against cancer', expects a record number of EU member states involved.
Collaborating with a greater number of member states provides an excellent opportunity to advance the achievements made during the last six years of joint actions, and to work together in an ever more cohesive manner. I am hugely optimistic and look forward to the further advances in cancer control that will emerge from such an innovative partnership.
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