81IN - Evolution of the pricing and reimbursement structure of cancer therapies in Europe

Date 29 September 2014
Event ESMO 2014
Session The impact on health services from personalised targeted therapies
Topics Bioethics, Legal, and Economic Issues
Presenter Richard Sullivan
Citation Annals of Oncology (2014) 25 (suppl_4): iv29-iv30. 10.1093/annonc/mdu308
Authors R. Sullivan
  • Research Oncology, Guy's and St. Thomas' Hospital NHS Trust, SE1 9RT - London/GB




Malignant neoplasms (cancer) are the second main cause of death after cardiovascular disease (CVD) in Europe and have a significant impact on the healthcare systems of the European Union (EU). Improving our public policy making on pricing and reimbursement mechanism is economic is essential to help evaluate the impact of public health policies and prioritize the allocation of future research and care funds. The economic cost of cancer was estimated for all the 27 countries of the EU as well as the proportion of total cancer costs due to the four main forms of cancer: lung, colorectal, female breast, and prostate. Differential pricing and reimbursement mechanisms were analysed against outcomes. Total costs comprised healthcare costs (e.g., primary care, hospital care), unpaid care costs by family and friends and lost earnings due to morbidity (absence from work) and premature mortality. The same methodological approach was used across all countries. Cancer was estimated to cost the EU €117 billion annually (€234 per EU citizen), with healthcare accounting for 36% of costs (€84 per EU citizen) and representing over 58 million hospital bed days. Lost earnings due to premature mortality and morbidity represented 36% and 8% of costs, respectively, while unpaid care accounted for the remaining 20%. Germany represented 26% of the total EU costs and there was considerable variation on the economic burden per person across the 27 countries. Lung cancer represented 16% of the overall cancer costs, followed by colorectal cancer (11%), breast cancer (10%) and prostate cancer (5%). The EU has a very heterogenous pricing and reimbursement patterns for cancer care, that have little policy coherence with outcomes. Our work suggests that cancer care and onco-economics cannot be seen as a Community activity and significant divergences will continue leading to greater inequity and, potentially, poorer outcomes in cancer.


R. Sullivan: RS has received speaker fees from Janssen, Novartis, Esai and Pfizer, and unrestricted educational grants from Pfizer and Novartis. All fees support the Institute of Cancer Policy.