141IN - Is personalised cancer care affordable?

Date 30 September 2012
Event ESMO Congress 2012
Session Society session - ESO - Celebrating 30 years of ESO and 50 issues of Cancer World. Cancer 2020: The road to personalized cancer care
Topics Bioethics, Legal, and Economic Issues
Personalised/Precision Medicine
Basic Principles in the Management and Treatment (of cancer)
Presenter Richard Sullivan
Authors R. Sullivan
  • Research Oncology, Kings Health Partners Integrated Cancer Centre, London/UK


Is Cancer Care and Research Becoming a Luxury Good? Affording Cancer in the 21st Century

Cancer has become one of the most intractable global diseases in both high income and increasingly in emerging economies. This complex and complicated disease has been a major focus for R&D since the 1970’s. Global public sector spend on cancer R&D has reached over 16.5 billion euros and disease specific R&D activity in cancer dominates all other areas with over 14% of total global activity. Within this research activity translational cancer medicine has expanded in only 20 years to account for nearly 40% of research outputs. In parallel the direct healthcare costs of cancer now consume between 5 and 10% of high income healthcare budgets, with particular areas such as imaging and pharmaceutical costs growing at an average annual rate of over 10%. The costs of both care and research are growing beyond the ability of countries to manage and deliver cost effective R&D and national cancer plans. The vast expansion in new technologies in cancer (NME, procedures, biomarkers, etc) coupled to rapid macro-economic (especially pricing) and socio-demographic measures is overwhelming the ability of national and trans-national systems to, a) effectively translate research through appropriately powered clinical trials, and b) deliver sufficient improvements in outcomes to merit the prices now being demanded. Cancer has reached both a crossroads and is on an apparent trajectory that could see the best care and fruits of research only available to affluent sectors of society. In this lecture we will explore the roots, trajectory and solutions to this convergent crisis and ask whether cancer care will become a luxury good; and whether the p-medicine agenda really can deliver tomorrows solutions or whether this is rapidly becoming a morally bankrupt paradigm that no-one will be able to afford.