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E-Poster Display

1592P - Happy wedding? Access and availability of oncology combination medicines


17 Sep 2020


E-Poster Display


Bioethical Principles and GCP

Tumour Site


Michele Pistollato


Annals of Oncology (2020) 31 (suppl_4): S903-S913. 10.1016/annonc/annonc287


M. Pistollato1, T. Wilsdon1, R.C. Steele1, J. Bercher2, A. Roediger3, M. Hartevelt4, M. Calvetto5, M. Van Meerveld3

Author affiliations

  • 1 Life Science, Charles River Associates International, Ec2m 7ea - London/GB
  • 2 Life Science, Charles River Associates International, 80802 - München/DE
  • 3 Oncology Policy Emeac, Merck Sharp & Dohme Corp. (MSD), CH-60101 - Kriens/CH
  • 4 Policy And Government Affairs, MSD New Zealand, 1023 - Auckland/NZ
  • 5 Marketing, MSD International Switzerland, 6000 - Luzern/CH


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Abstract 1592P


The increasing development of combination medicines has been a key component in the move towards personalisation of medicine, delivering significant benefits to patients. However, there are challenges to ensuring all patients have access; to oncology combinations. Here we investigate these challenges and the national approaches in Europe to provide access to oncology combinations.


This study is based on an analysis of the availability and access delays for combination products across EU 27 plus Australia, Canada, Switzerland and UK. Deep-dive analysis is performed on seven European countries to identify barriers to access and usage of oncology combination products. Current national approaches, the current debate and proposed solutions are also investigated. This is supplemented by cross stakeholder interviews.


There is a large divergence in the value assessment, time to reimbursement and availability for oncology combination products across Europe, Australia and Canada. This is a result of a range of interconnected access barriers including healthcare infrastructure, evidence generation and assessment, process and legal barriers. A particular problem is the value assessment and pricing of combinations of different manufacturers due to competition law limitations. Policy solutions have been proposed by international organisations, while countries including France, England and Sweden are implementing national approaches to address these issues.


Combination therapies provide considerable value to patients. At the same time, there are several challenges preventing patients having timely access to innovative oncology combinations. Ultimately, without appropriate policy solutions there may be further delays or restrictions to access of these vital medicines; which, in turn, may disincentivise further research and clinical development of future combinations. Although some organisations have proposed policy solutions, further work must be done to ensure progress is made at the national level. This study aims to provide a more detailed background to inform policy debates.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA.


Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA.


M. Pistollato; T. Wilsdon; R.C. Steele; J. Bercher: Advisory/Consultancy, This study is funded in full by Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA.: Merck Sharp & Dohme Corp. (MSD). A. Roediger; M. Hartevelt; M. Calvetto; M.G. Van Meerveld: Full/Part-time employment, This study is funded in full by Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA.: Merck Sharp & Dohme Corp. (MSD).

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