On A "European Cancer Plan"

With momentum growing for a European Cancer Plan, there is a real opportunity to make a difference for cancer patients in Europe in the next term of the European institutions, writes Deepak Khanna.

Deepak Khanna is Senior Vice-President Oncology for Europe Middle East Africa and Canada (EMEAC) at MSD, which is hosting the European Cancer Forum on 4 December at the Solvay Library in Brussels in collaboration with Lung Cancer Europe (LuCE) and the European Cancer Patient Coalition (ECPC).

Almost everyone has a friend or relative who has been affected by cancer. Cancer is the leading cause of death in Europe after cardiovascular diseases, and the burden is rising. Because this challenge is so huge, there is not a single solution, nor can one actor tackle it alone.

As a society, we have a joint responsibility for cancer patients across Europe to work together towards a European Cancer Plan.

The idea for a European Cancer Plan has growing momentum. In his first speech as his party’s Spitzenkandidat, Manfred Weber promised to deliver an “EU master plan for fighting cancer” if he is elected in 2019.

The EPP’s candidate is the frontrunner to become European Commission President, and support for a cancer plan at this political level could make a huge difference to the lives of millions of Europeans.

Weber is not the only one calling for a European Cancer Plan. There is clear cross-party support for such an initiative, with ALDE MEP Lieve Wierinck recently championing the idea. She has emphasised the urgent need for large-scale investment and more effective coordination of national cancer policies.

Different stakeholders have different views on what a cancer plan could look like, and I look forward to discussing it with other leading voices in the cancer policy area during the European Cancer Forum in Brussels on 4 December.

But there seems to be a consensus that such a plan must balance three objectives: foster innovation, equal and timely access, and the sustainability of health systems.

Firstly, we as an industry must continue to innovate. In recent decades, together with other medical advances in areas such as surgery, screening and prevention – new, innovative medicines have contributed to real progress in the fight against cancer and the survival in many cancer types has risen.

Some examples of positive changes in the 5-year survival rate (1970 compared to 2016) include breast cancer from 40% to 90%, Hodgkin’s disease from 10% to 90%, and leukaemia in children from 10% to 90%. More recently, immunotherapies have dramatically changed the outlook for many melanoma and other cancer patients.

Despite this progress, 5 out of 10 people globally still die of cancer today. The 5-year survival for lung cancer patients has only risen from 10% in 1970 to 20% in 20161. Improving outcomes for cancer patients requires that industry continues to be ambitious and invests in research and development, now and in the future.

The European Cancer Plan must commit to supporting the pioneering research that goes into these breakthroughs, and include new treatments in national cancer plans, treatment pathways and funding streams.

Secondly, the European Cancer plan must make bold political choices. Not everyone in Europe has access to cancer care. To overcome health inequalities, the Plan will need to be ambitious and set priorities.

For example, bridging the gap between Regulatory Agencies and health technology assessments (HTA) is an opportunity to accelerate access and ensure that every cancer patient receives the cancer care they need.

We must capture this opportunity to promote meaningful cooperation between national health systems, the HTA network and industry to reduce inequalities in patient access to cancer care.

Finally, there is no access without sustainable financing. Spending on cancer in Europe has been stable in recent years. Although cancer is the second biggest disease burden, only approximately an average of 6% of total healthcare expenditure in the EU is spent on cancer care.

As there will be new treatment options in the future we need to make sure that financial resources are available. We are keen to work with government and payers to develop solutions which ensure timely access and budget predictability. Sustainable access is a joint responsibility.

Several member states have developed frameworks to secure timely and sustainable access. Belgium created the “Pact of the Future”; Italy set up an innovation fund; and the UK has transformed the Cancer Drugs Fund (CDF) into a scheme that provides timely access while sharing risks amongst stakeholders equally.

There are also many other approaches where collaboration between stakeholders has been successful.

Every one of us would like to live in a world where cancer can be cured.

Every one of us wishes timely and equal access.

A European Cancer Plan would be a joint commitment and could bring us closer to that goal.