More than 5000 patients with metastatic melanoma in Europe per year do not have access to new life-saving drugs

Date

10 Oct 2016

Session

Public health and health economics

Presenters

Lidija Kandolf Sekulovic

Citation

Annals of Oncology (2016) 27 (6): 1-36. 10.1093/annonc/mdw435

Authors

L. Kandolf Sekulovic1, K. Peris2, A. Hauschild3, L.V. Demidov4, P. Nathan5, C. Lebbe6, C. Hoeller7, C.U. Blank8, J. Olah9, H. Gogas10, R. Dummer11, L. Bastholt12, D. Herceg13, A. Stratigos14, B. Neyns15, J. Hansson16, P. Rutkowski17, A. Forsea18, I. Krajsová19, C. Garbe20

Author affiliations

  • 1 Department Of Dermatology, Interdisciplinary Melanoma Team, Military Medical Academy, Medical Faculty, 11000 - Belgrade/RS
  • 2 Dermatology, Catholic University of the Sacred Heart, Rome, Italy, Rome/IT
  • 3 Department Of Dermatology, University Hospital Schleswig-Holstein, 24105 - Kiel/DE
  • 4 Tumor Biotherapy, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
  • 5 Department Of Medical Oncology, Mount Vernon Cancer Centre, HA6 2RN - Northwood/GB
  • 6 Aphp Service De Dermatologie, INSERM U976 Hôpital Saint Louis, 75475 - Paris/FR
  • 7 Dpt. Of Dermatology And Dermatooncology, Medizinische Universitaet Wien (Medical University of Vienna), 1090 - Vienna/AT
  • 8 Medical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
  • 9 Department Of Dermatology And Allergology,, University of Szeged, Szeged/HU
  • 10 Medical Oncology, Laikon General Hospital, National and Kapodistrian University of Athens, 115 27 - Athens/GR
  • 11 Department Of Dermatology, Universitätsspital Zürich, 8091 - Zürich/CH
  • 12 Dept. Of Oncology, Odense University Hospital, DK-5000 - Odense C/DK
  • 13 Clinic Of Oncology, School of Medicine University Zagreb University Hospital Center Zagreb, 10 000 Zagreb - Zagreb/HR
  • 14 Dermatology, National and Kapodistrian University of Athens, Athens/GR
  • 15 Oncology, UZ Brussel, 1090 - Brussels/BE
  • 16 Department Of Oncology-pathology, Karolinska University Hospital, Stockholm/SE
  • 17 Soft Tissue/bone Sarcoma And Melanoma, MSC Memorial Cancer Centre and Institute Maria Sklodowska-Curie, 02781 - Warsaw/PL
  • 18 Dermatology, Universitatea de Medinina si Farmacie Carol Davila, Bucharest/RO
  • 19 Department Of Dermato-oncology, VFN a 1. LF UK Praha, Prague/CZ
  • 20 Deptartment Of Dermatology, University Hospital Tuebingen, 72074 - Tübingen/DE
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Background

Despite the efficacy of innovative treatments for metastatic melanoma their high costs has led to disparities in cancer care among different European countries. We analyzed the availability of these innovative therapies in Europe, and estimated the number of patients without access to first-line recommended treatment per current (ESMO, EORTC/EADO) guidelines.

Methods

Web-based online survey was conducted in 34 oncology centers from 29 European countries with questions about the treatment schedules from 1st May 2015-1st May 2016: number of metastatic melanoma patients, percentage of patients treated with any of the new agents, data on registration and reimbursement of innovative medicines and availability of clinical studies for stage IV disease. Descriptive statistics were used to analyze the data.

Results

In Western European countries at least 70% of patients were treated with innovative medicines, while in 41% of centers from Eastern and SE Europe less then 10% of patients had an access. Recommended first-line therapy for BRAF mutated metastatic melanoma, BRAFi + MEKi combination was registered in 75% and fully reimbursed in 58% countries of Western Europe, while in Eastern and SE Europe it was registered in 42% and reimbursed in 3/17 (18%) countries. First-line immunotherapy with any of the anti-PD1 antibodies was registered in Western Europe in every country while in Eastern and SE Europe it was registered in 10/17 (59%), but reimbursed in 4/17 (23.5%) countries. Based on estimated total number of metastatic melanoma patients and percentage of patients treated with innovative therapies, it can be estimated that at least 5000 of patients in Eastern and South-Eastern Europe do not have access to innovative treatments for metastatic melanoma.

Conclusions

Great discrepancy exists in metastatic melanoma treatment across Europe. It is crucial to increase the awareness of national and European policy makers, oncological societies, melanoma patients associations and pharma industry. *Additional contributors: Bylaite-Bucinskiene M, Zalaudek I, Maric-Brozic J, Vieira R, Babovic N, Kukushkina M, Banjin M, Putnik K, Weinlich G, Todorovic V, Kirov K, Risteski M, Ocvirk J, Ymeri A, Zhukavets A.

Clinical trial identification

Legal entity responsible for the study

European Association of Dermatooncology

Funding

European Association of Dermatooncology, but no funding was needed for the study

Disclosure

All authors have declared no conflicts of interest.

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Invited discussant

Presenter: Tit Albreht

Session: Public health and health economics

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