Abstract 4118
Background
Immune checkpoint inhibitors (ICI) have revolutionized treatment of advanced NSCLC. In France, concerns have been raised as to the financial burden of these therapies and fear that potential patients may be ruled out. The reality of budgetary restrictions implies for choices to be made considering both the quality of life these treatments procure as well as the financial burden they represent. From a physician’s point of view, due to financial constraints on public health facilities, physicians could restrain themselves from prescribing innovative expensive therapies.
Methods
This qualitative study questions the potential impact of drug prices on prescription choices made by thoracic oncologists. Ten French oncologists and two hospital pharmacists voluntarily underwent a semi-structured interview conducted by a student in an Ethics master’s degree. Interviews consisted of two distinct parts: one clinical case where treatment choices had to be made in the first-line and second-line advanced NSCLC setting and a second part consisting of open-ended questions.
Results
Qualitative analysis of the interviews brings out that immunotherapy has radically changed the history of cancer treatment but that hopes in advanced NSCLC need to be tempered. Efficacy in a real-world setting is difficult to predict and efforts need to be made to identify accurate biomarkers. Financial matters are a source of discussions between fellow physicians and clinical pharmacists but not with patients. Physicians consider they have a duty to strictly respect guidelines particularly in a French universal healthcare system.
Conclusions
Rising costs of innovative drugs in oncology is a reality that forces a reconsideration of healthcare and drug regulation systems in order to be able to provide access to innovation for all eligible patients in the French universal healthcare system. Addressing this issue with physicians provides important insight on how treatment choices are made, their expertise and their involvement in this matter. Physicians are concerned about access to innovation for their patients and consider they ought to remain aware of these issues in order to participate in healthcare arbitration discussions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Laboratoire Ethique Médicale - Université Paris Descartes.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3517 - Role of follow-up (FU) FDG-PET/CT (FU-FDG-PET/CT) in patients with locoregionally advanced squamous cell carcinoma of the head and neck (LA-HNSCC) treated with chemotherapy and radiotherapy (RT), either concurrent (CRT) or sequential (ST).
Presenter: Bert Van Den Heuvel
Session: Poster Display session 3
Resources:
Abstract
5071 - Expression of estrogen receptor and programmed cell death-ligand 1 can be complementary prognostic factors in HPV-positive oropharyngeal squamous cell carcinoma
Presenter: Soohyeon Kwon
Session: Poster Display session 3
Resources:
Abstract
5306 - Real-world data of clinicopathologic characteristics of young oropharyngeal cancer patients.
Presenter: Maria Nieva
Session: Poster Display session 3
Resources:
Abstract
3407 - The clinical significance and biological mechanisms of miR-499a in high-tobacco exposed head and neck squamous cell carcinoma
Presenter: Shiqi Gong
Session: Poster Display session 3
Resources:
Abstract
3310 - Liquid biopsy for mutational profiling of locoregional recurrent and/or metastatic squamous cell carcinoma of the head and neck
Presenter: Rachel Galot
Session: Poster Display session 3
Resources:
Abstract
2362 - Blood-based testing of mutations in patients with Head and neck squamous cell carcinoma (HNSCC) using highly sensitive SafeSEQ technology
Presenter: Florentia Fostira
Session: Poster Display session 3
Resources:
Abstract
4533 - The head and neck Lung Immune Prognostic Index (HN-LIPI): a prognostic Score for Immune Checkpoint Inhibitors (ICI) in Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (R/M SCCHN) patients.
Presenter: Ruth Gabriela Herrera Gomez
Session: Poster Display session 3
Resources:
Abstract
5262 - Immune-related adverse events (irAEs) and outcome in recurrent/metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) patients (pts) treated by immune-checkpoints inhibitors (ICI)
Presenter: Neus Baste Rotllan
Session: Poster Display session 3
Resources:
Abstract
3725 - Intratumoral and peripheral exploratory biomarker analysis in patients with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC) treated with RM-1929 photoimmunotherapy
Presenter: Jack Bui
Session: Poster Display session 3
Resources:
Abstract
2533 - A nomogram based prognostic score to predict overall survival (OS) in recurrent-metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts) treated with immune checkpoint inhibitors (ICI).
Presenter: Luay Mousa
Session: Poster Display session 3
Resources:
Abstract