Securing against shortages
Any new EU cancer plan must take steps to address the growing problem of medicines shortages through measures to secure manufacture within Europe, says Nathalie Colin-Oesterlé.
In 2018, the WHO recorded 18.1 million new cancer cases worldwide. It foresees this rising to 29-37 million by 2040.
In France, cancer, rather than cardiovascular disease, has been the leading cause of premature death; this has been the situation for more than 15 years. Unfortunately, it is not the only EU Member State where this is the case.
We are all concerned by this major health priority; the launch of a European plan to fight cancer is essential.
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The European Union can, in fact, provide tremendous leverage on tackling cancer, offering real added value and will therefore play a major role. It is clear there are many elements to making a major European plan a reality.
We must reinforce and pool all Europe’s resources dedicated to research and innovation and harmonise our policies on public health and citizen information and develop prevention and screening.
We must also facilitate the release onto the market of medicines and provide support for patients and their families.
“There is an urgent need for Europe to relocate its pharmaceutical manufacturing industries to where it has greater control”
The fight against drug shortages is another element. These shortages are becoming increasingly frequent and are lasting longer.
In France, they have multiplied twentyfold since 2008 and principally affect cancer treatments.
The causes are varied and complex, including increasing world demand, offshoring production, the adoption of just-in-time inventory management, the challenge of profitability and fragmented supply and production chains.
However, few initiatives to address this at European level have seen the light of day. True, Member States have taken their own measures, particularly in France, but these have been without any viable, long-term solution.
Public health problems such as drug shortages are currently in the public eye, in the light of the coronavirus outbreak and the associated crisis we are experiencing.
Awareness of the risk to health is real, both among citizens and among political leaders, associated principally with our dependence on third countries.
“How can we justify, in this day and age, that for the same pathology, a patient may have access to a treatment in one Member State but not in another?”
Indeed, to a large extent, drugs are no longer manufactured in France – not even in Europe - but rather in China or India, where labour costs are lower.
Around 80 percent of APIs (active pharmaceutical ingredients) are now manufactured in Asia, compared with only 20 percent thirty years ago.
In the event of a global pandemic such as coronavirus, the weakening of China has an influence on its production of raw materials bound for the pharmaceutical industry.
This in turn has an impact on production chains, particularly those in Indian ones, which import 70 percent of their active ingredients from China.
While India announced a few days ago that it would be reducing its exports of drugs by 10 percent in order to support its national stock levels, it demonstrated how the European Union remains vulnerable and devoid of alternatives.
There is an urgent need for Europe to relocate its pharmaceutical manufacturing industries to where it has greater control.
The offshoring of production has been the root cause of many of the recent shortages. Our role should be to guarantee an economic area that is viable for fi rms and laboratories to maintain investment not only research and innovation in Europe but also manufacture.
The players must also play the game in the general interest: guarantee to maintain European production and permit access to drugs for all.
I want this cancer plan to also be the chance to launch a European health forum that brings together all stakeholders (Member States, pharmaceutical industry, distributors, patients, etc.) in order to analyse all the causes of these shortages and formulate effective recommendations.
Inventory management, delivery, availability of treatments in each Member State are also factors.
How can we justify, in this day and age, that for the same pathology, a patient may have access to a treatment in one Member State but not in another?
There is an urgent need for global analysis of this situation if we are to provide real responses.
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