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Poster Discussion - Public policy

3453 - Accessibility and Affordability to Trastuzumab for Breast cancer patients: voices of the Global Oncology community from ONCOLLEGE 001 survey – part 2


29 Sep 2019


Poster Discussion - Public policy


Sara Altuna


Annals of Oncology (2019) 30 (suppl_5): v671-v682. 10.1093/annonc/mdz263


S.C. Altuna1, D. Trapani2, C. Lengyel3, B. Habeeb4, S. Hussain5, S. Mazher6, E. Elfaham7, A. Petrillo8, K. EL BAIRI9, S.Z. Khan10

Author affiliations

  • 1 Department Of Medical Oncology, Unidad Oncológica Molecular Venezuela, 1040 - Caracas/VE
  • 2 Department Of Hematology And Oncology, Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 3 Head And Neck Surgery Department, National Institute of Oncology Hungary, 1122 - Budapest/HU
  • 4 Medical Oncology Department, Shaqlawa Teaching Hospital, 44001 - Erbil/IQ
  • 5 Oncology Department, King Abdulaziz Medical City, 12746 - Riyadh/SA
  • 6 Department Of Oncology, Baptist Health Medical Center, 72223 - Little Rock/US
  • 7 Medical Oncology Department, Alexandria University Students Hospitals, Alexandria/EG
  • 8 Department Of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 - Napoli/IT
  • 9 Cancer Biomarkers Working Group, Mohamed 1st University, 60000 - Oujda/MA
  • 10 Department Of Clinical Oncology, BINOR Cancer Hospital, 28100 - Bannu/PK


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Abstract 3453


ONCOLLEGE-001 project surveyed the global accessibility (ACC)/ affordability (AFF) to HER2-testing (H2T) & medicines for breast cancer (BC). The 1st analysis showed critical issues of ACC & AFF of H2T in lower- middle income countries. Part 2 of the survey focuses on ACC, AFF and prioritization of anti-HER2 medicines; here, we present the data for trastuzumab (T).


An internet-based survey was developed by the international ONCOLLEGE working group. Data were analyzed per country-income (World Bank groupings) and World Health Organization Regions. Responders authorized for the use of the data.


Responses were received from 210 providers (78% medical or clinical oncologists) across 45 countries (all income groups, all regions). 8% of providers reported no T available in their setting, of which 60% are from low and low-middle income countries (LMICs) and the remaining from upper- middle (UMIC). Where T was available, 15% of the responders reported ACC only as out of pocket expenditure (OOP) for patients, of which almost 70% from LMICs. More than 2/3 of the responders described to order the H2T regardless ACC to affordable trastuzumab for patients, retaining the prognostic information of HER2- overexpression to inform treatment decision- making (e.g. risk grouping for early breast cancer). The patterns of reimbursement for T influenced the percentage of eligible HER2 patients receiving the anti-HER2 drug: T is received in more than 50% of the eligible population in 8%, 41% and 74% in LMIC, UMIC and HIC (high- income) settings, respectively. In 71% of settings where trastuzumab is provided only as OOP, <1/4 of the eligible patients could access affordable T.


The heterogeneous pattern of ACC and AFF of H2T & anti-HER2 medicines influenced the chance of breast cancer patients to receive T. Data on the use of trastuzumab biosimilars and other HER2 blockers is under analysis. International systematized cross-cutting and comprehensive efforts across the cancer continuum are warranted to inform and shape the areas of research implementation for cancer - aiming to optimize the cure and care for all cancer patients and prevent catastrophic OOP.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

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