Confronting inequalities in European cancer treatment

Inequalities in access to cancer treatments and care vary across Europe and the European Cancer Patient Coalition is working to remedy this situation through investigating and publicising the causes of these differences and supporting MPs to create policies to address and solve the issues.

The European Cancer Patient Coalition (ECPC) recognises the disparities in cancer care across Europe and is working to draw attention and redress the balance through giving voice to the differences in a number of ways.

As the largest cancer patient umbrella group in Europe, it represents 351 patient groups and 46 countries in Europe, and was established to fight all cancers, common and rare. It is run and governed by patients and works to involve them in health policy, clinical decisions and the processes affecting them.

As a result of concerns raised by its members, the ECPC is pushing to establish a multi-party working group that will draft a Position Paper on cancer-related health inequalities in Europe, to be launched in June.

Towards this goal, last week it – along with Elisabetta Gardini, leader of the Italian European People's Party (EPP) – brought together a panel of international health experts to help identify the main factors causing inequalities in cancer care at a meeting entitled 'Europe of Disparities' at the European Parliament in Brussels.

MEP Gardini stressed the importance of the European Parliament in closing the gap between civilians and European institutions, saying "More than 10 million Europeans are affected by cancer. This issue deserves the Parliament's attention and in particular ENVI's [The Committee on the Environment, Public Health and Food Safety] pro-activeness. Cancer costs us €126 billion/year – more than half of this huge cost burden lies solely on patients and their families. We have a responsibility to change these figures, transforming a Europe of Disparities into a Europe of equity, fairness and opportunities."

The scene was set by the screening of a video documentary made by Romanian director Claudiu Mitcu, called 'The Network', which was based on an article by health journalist Vlad Mixich.

The film showed how people have overcome cancer inequalities in Romania. It gave a brief overview of the plight of cancer patients in that country where, over the last 10 years, shortages of essential low-cost cancer drugs have affected the lives of thousands of patients. As is the case in most other European countries, cancer treatment is available by law to every individual there. However, until recently, shortages meant long delays in the administration of treatments. In many cases, Romanian patients were unable to even start treatment, which significantly decreased their chances of survival.

"Over 400 people living in Western Europe, their acquaintances or tourists bought the drugs, usually out of their own pockets, and 'smuggled' them into Romania"

In response, an informal group of volunteers from different countries, now known as 'The Cytostatics Network', came together to ensure Romanian patients would have access to drugs. For five years, over 400 people living in Western Europe, their acquaintances or tourists bought the drugs, usually out of their own pockets, and 'smuggled' them into Romania. There was even a website launched called 'Missing Drugs' where Romanian patients could find volunteers to send them the drugs they needed.

Of the 17 cancer drugs listed by the World Health Organization (WHO) as the most essential for cancer patients, about half were not available for patients in Romania.

However, extensive media coverage of the article and documentary put pressure on the Romanian government, resulting in it making the drugs available since January 2014.

This story is a perfect example to illustrate the ECPC belief that people power and collaboration does work.

ECPC president Prof De Lorenzo praised the European Commission's efforts to bring together all the stakeholders in cancer care, including health ministers, EU institutions, medical societies, industry and patients. However, he called for the research and opinions garnered to be translated into political proposals as soon as possible.

Prof Richard Sullivan, director of the Institute of Cancer Policy at King's Health Partners in the UK, explained that cancer care systems are very complex, meaning that countries that spend more on cancer do not necessarily get better outcomes. He stressed that national and European public policy needed close scrutiny and change, otherwise Europe would end up with public cancer care systems that were "like a supermodel with a Louis Vuitton handbag: lovely to look at, very expensive, affordable to only a few and of no real value to society as a whole".

"Prof Francesco Perrone from the Cancer Institute 'Pascale' in Naples, Italy, suggested a single European price for new drugs"

Prof Francesco Perrone from the Cancer Institute 'Pascale' in Naples, Italy, suggested a single European price for new drugs, which would be adjustable to each Member State's particular circumstances in terms of purchasing power and GDP, for example. However EFPIA's director for governmental affairs, Ms Gabriella Almberg, cautioned: "It will be very difficult to bring all Member States together to agree on a price, given the differences in the healthcare priorities and in the reimbursement systems. There's a clear correlation between wealth and access and so a single price across Europe with such differing GDPs would be difficult."

Another recent ECPC-EU-funded programme highlighted at the meeting is eSMART, a pioneering research project that could transform cancer care and significantly reduce healthcare costs by enabling cancer care clinicians to use mobile phone technology to monitor patients undergoing chemotherapy treatment for breast, bowel and blood cancers.

The ECPC and speakers from all over the world were clearly passionate about reducing inequalities and improving the quality of cancer care for patients in Europe. Their direct involvement in research projects, work in raising awareness about initiatives affecting cancer patients and participation in legislative and policy changes taking place at EU level have, and will continue to, benefit patients across Europe.

Following on from the launch event, a working group will be established this month to produce a policy paper on cancer care inequalities, with the results to be published in June 2015 at the ECPC AGM in Brussels. Anyone wishing to join the working group should contact Francesco Florindi on email: francesco.florindi@ecpc.org

About the author:

Louise Bellamy is senior manager, Healthcare Partners at pharmaphorum. Louise's background is in project management, having worked for almost 10 years across a number of industries, including market research, translation and publishing. Healthcare Partners is a unique educational programme focusing on innovation in cancer. Find out more at www.healthcare-partners.net or @hc_partners.

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