ESMO announces evidence-based methodology to support equitable access to cancer services

Ahead of World Cancer Day and its campaign to “Closing the Care Gap”, ESMO is announcing a methodology designed to enable governments and other cancer stakeholders globally to make decisions about effective spending that supports equitable access to cancer services within their populations. The generalizable model, published today in the open-access, peer-reviewed journal ESMO Open, was originally developed to help key stakeholders in Kazakhstan update and streamline the national list of essential cancer medicines. and treatment protocols.

Offering an evidence-based methodology for the evaluation of national drug formularies that is based on freely accessible and validated tools, this approach constitutes a practical aid for decision-makers in order to maximize the impact of their cancer control programs, their to invest in treatments that offer the best value for money.”

Pr Solange Peters, President of ESMO

The ESMO President further underlined that the open source approach could be replicated independently by national health authorities and governments anywhere, thus making ESMO’s commitment tangible, shared with the Day against cancer, to ensure that every cancer patient receives the best treatment for them, regardless of who they are. they are or where they live.

Faced with a high cancer burden accompanied by rapidly rising costs of cancer care, Kazakhstan collaborated with WHO and in 2017 ESMO was contracted as an expert to review the national formulary drugs and treatment protocols in oncology.

In a four-phase approach described in the ESMO-WHO article, a comprehensive list of all cancer drugs used in Kazakhstan was created and cross-checked against the WHO Model List of Essential Medicines, therapeutic indications for European Medicines Agency (EMA) database and, where available, ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) scores were provided. National treatment protocols for different types of cancer were also compared with recommendations from ESMO Clinical Practice Guidelines. Following an expert review of the results, ESMO shared a summary report based on the collected evidence with the WHO, to enable further dialogue with health authorities in Kazakhstan.

According to co-author and chair of the ESMO-MCBS working group, Professor Nathan Cherny, Shaare Zedek Medical Center, Israel, ESMO’s validated and publicly available evidence-based tools have helped identify the changes that the Kazakhstan could implement in a budget-constrained policy-making process. environment to remove structural barriers to accessing high-quality care in the country. “The ESMO-MCBS scoring of medicines based on their actual clinical benefit and the emphasis on sustainability by the ESMO guidelines has enabled prioritization of high value-added treatments to achieve the best possible balance between financial viability of the health system and the need to provide all patients with care,” he said.

As a result, Kazakhstan has actually increased its total cancer care budget by demonstrating value for money and focusing on essential and highly effective treatment options. This included updating 45 treatment protocols for solid and blood cancers and adding 13 new targeted drugs to the national benefit package, while removing eight low-value drugs from the formulary. “The efficiencies and quality improvements in cancer care achieved in Kazakhstan are proof of principle for the model we are proposing and confirm the usefulness of ESMO’s resources not only for individual physicians, but also for governments and public health authorities,” Cherny said. Underline.

Co-author André Ilbawi from the Department of Non-Communicable Diseases, WHO, reaffirmed the importance of data-driven priority setting and partnerships as essential steps to sustainably improve cancer care in globally, principles further highlighted in the joint WHO-ESMO editorial: “Increasing access to quality cancer care requires that cancer control programs are evidence-based, based on equity and solidarity, and optimize resources. WHO, ESMO and key stakeholders in Kazakhstan have been able to harness the potential of universal health coverage,” he said.

Ilbawi added: “WHO and ESMO have established a model that can help other governments strengthen their cancer control programmes, ensuring that all populations have access to quality cancer care. cancer, today and in the decades to come.”

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