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By Dr Ward Rommel, Chair, Access to Medicines Task Force, Association of European Cancer Leagues (ECL)  –  @CancerLeagues & @WardRommel | #LetsTalkAccess

If you have cancer and you need medicine, you should be able to get it. Everyone agrees but, sadly, progress toward providing access to safe, affordable, and effective medicines to cancer patients has stalled across Europe. As demonstrated by OECD (2020), access to new cancer drugs is disturbingly uneven across Europe, with Central and Eastern European countries lagging behind. What is more, the launch prices of cancer drugs have more than doubled over the last 20 years making it very challenging for health systems even in the wealthiest European countries to provide timely access to therapies providing high clinical benefit. It is not all doom and gloom, as thanks to new treatments like immunotherapy, survival in lung cancer has improved. 

Doing things collaboratively 

In October 2020, WHO Europe launched the Oslo Medicines Initiative (OMI), marking a historic declaration of intent to reshape the political discourse and build an environment of mutual trust and cooperation between the pharmaceutical industry, governments, civil society, payers and patients. In the words of the Regional Director of WHO Europe, Dr Hans Henri P. Kluge “The Oslo Medicines Initiative is about fixing what’s broken. Inequitable access and unaffordable medicines are preventing us from making health coverage universal. Together we can change that”. 

Supported by consultations, technical reports and webinars, the OMI culminated in a high-level Ministerial Lunch at the 72nd session of the WHO Regional Committee for Europe in Israel on 12 September 2022. Since 2020, civil society organisations, including the Association of European Cancer Leagues (ECL), have followed the development of the OMI closely and with great interest. WHO Europe will soon convene a neutral platform, bringing together all stakeholders. This is a unique opportunity!   

Until 2020, we mostly talked among allies, preached to the converted, argued with opponents and did not find many common grounds. Patients and civil society expect the right to fairly priced drugs that meet their needs, while the pharmaceutical industry and shareholders expect to make profits to balance drug development’s inherent risks. The current pharmaceutical model, with its drive to make high returns to investors means that we are not improving the health of the population as quickly as possible. 

Cross-border collaboration is key 

ECL firmly believes that solidarity, ethics and openness are the keys to affordability. The global COVID-19 pandemic proved that different people and sectors can come together to find a fair solution to problems without borders but also put a spotlight on the generalised lack of transparency, and inequalities which result from the way that the pharmaceutical markets are working now.  It is crucial to think about what solidarity means in practice and how all stakeholders can best work together and implement pragmatic step-by-step solutions.

In our statement following the OMI Ministerial Lunch, we list several possible solutions to address the multifactorial and complex challenges related to access to new cancer therapies, including (i) adopting a fair pricing policy that takes into account the ethical and financial dimensions of patient access to care, affordability and sustainability of healthcare systems, (ii) increasing transparency of end-user prices, the cost of research and development, the cost of goods, as well as of public health authorities’ decision-making processes (iii) ensuring that pharmaceutical policy is truly evidence-based and applying new scientific evidence into practice and (iv) exploring new models of drug development and incentivising non-commercial and academically-driven medicine development.

Keep up the good work 

A great deal needs to be done and the OMI is only the start.   

Ensuring that everyone everywhere has access to the cancer medicines they need will require much more open dialogue between the public, private and third sectors to find common ground on controversial topics and find transparent, sustainable solutions that are of benefit to all patients. Ultimately drugs should improve the overall survival and quality of life of patients. Patient-centeredness and participatory decision-making must be at the heart of any conversation on drug development, manufacturing, and pricing.

At the EU level, the Pharmaceutical Strategy for Europe and Europe’s Beating Cancer Plan must take into account results and evidence from the OMI. Cancer leagues look forward to playing a key role in the proposed OMI multi-stakeholder platform. This platform should be organised so that dialogue can take place in a balanced way.  Cancer leagues also look forward to playing an active role in the revision of the basic pharmaceutical legislation, as much more ambitious legislation is urgently needed to trigger the systemic changes necessary in the incentives and obligations system.  

Imagine what we could achieve if we could develop a pharmaceutical system that makes safe and effective medicines swiftly available to all patients in Europe. We have the technology, know-how and manpower to achieve this.